UC-NRLF 


RC 


B    a    111    063  1 

K.fUKl    OF    THE    COMMISSION 


TO 


INVESTIGATE  THE  EXTENT 


or 


FEEBLEMINDEDNESS,  EPlLEPsy  AND  INSANITY 


Oilier  Conditions  of  Mental  Defectiveness 


•IN   MICHIGAN 


-VSA/VV^ 


LANSING,   MICHIGAN 
WYNKOOP   IIALLRNBRCK   CUAVVKORD  CO..   STATE  TRINTERS 

1915 


EXCHANGE 


REPORT   OF    THE   COMMISSION 


TO 


INVESTIGATE  THE  EXTENT 


OF 


FEEBLEMINDEDNESS,  EPILEPSY  AND  INSANITY 


AND 


Other  Conditions  ol  Mental  Defectiveness 


IN   MICHIGAN 


LANSING.  MICHIGAN 
WYNKOOP   IIALLENBECK   CltAWFQUD   CO.,   STATE  PRINTERS 

1915 


o 


•     .    • 


1"U 


/I 


CONTENTS. 


Introduction 
Chapter  I. 


The  Insane 

Prevalence  of  Insanity 

Increase  of  Insanity 

Source  of  Increase 

Influence  of  Locality 

Influence  of  Foreign  Population 

Influence  of  Sex 

Influence  of  Age 

Influence  of  Occupation 

Influence  of  Alcohol 

Influence  of  Drugs 

Influence  of  Syphilis 

Influence  of  Heredity 

Summary 

Conclusions 

General  Conclusions ; 

Chapter  II.     The  Feebleminded  and  Epileptic 

Introduction 

Feeblemindedness  in  relation  to  Delinquency  as  studied  at  the  Adrian  Industrial 
Home  and  the  Lansing  Industrial  School. 

Introduction 

Mental  Status 

Grade  and  Age  of  leaving  School 

Physical  Factors 

Occupational  History 

Delinquent  Record 

Habits — Sex  and  Alcohol 

Other  General  Facts ^. . . . 

Facts  Relating  to  Family 

Civil  Condition  of  Parents 

Feeblemindedness  in  Relation  to  Dependency  as  studied  in  the  County  Infirm- 
aries of  the  State. 

Introduction 

Mental  Classification 

Insane  in  County  Infirmaries 

Nativity 

Age .' 

Education 

Occupation 

Habits 

Facts  Relating  to  Physical  Condition '. 

Facts  Relating  to  Civil  Condition 

Sex  in  Relation  to  Dependency  and  Defectiveness 

Summary  of  Causes  of  Dependency , 

Feebleminded  in  the  County  Infirmaries 

Summary  and  Conclusion 

Recommendations .  .  


Page 
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72 
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76 
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80 
84 
86 
88 
105 
107 


LIST  OF  MAPS. 


Map 

I. 

Map 

II. 

Map 
Map 
Map 

III. 

IV. 

V. 

Map 

VI. 

Map 

VII. 

Map  VIII. 

Page 
Average  yearly  rate  per  10,000  population  of  a(lmission.s  to  Michigan  State  Hos- 
pitals from  each  county  for  the  10-year  period  ending  June  30,  1912 18 

Average  ratio  per  10,000  of  foreign  born  to  total  population  of  Michigan,  1900 

to  1 910 '. : 19 

Per  cent  of  County  Infirmary  population  which  is  insane  or  defective 63 

Per  cent  of  County  Infirmary  population  which  is  feebleminded  or  epileptic. ...  64 

Total  of  all  foreign  born  in  County  Infirmaries.     Ratio  per  10,000  foreign  born 

populati  on 65 

Normal  foreign  born  In  County  Infirmaries.     Ratio  per  10.000  foreign  born 

population 71 

Feebleminded  and  epileptic  foreign  born  in  County  Infirmaries.     Ratio  per 

10,000  foreign  born  population 72 

Total  insane  and  defective  foreign  born  in  County  Infirmaries.    Ratio  per  10,000 

foreign  born  population 73 


Diagram 
Diagram 
Diagram 
Diagram 
Diagram 
^Diagram 


I. 

II. 
III. 
IV. 

V. 
VI. 


Diagram     VII. 

Diagram   VIII. 
Diagram       IX. 

Diagram        X. 

Diagram       XI. 
Diagram     XII. 

Diagram  XIII. 

Diagram   XIV. 

Diagram      XV. 

Diagram    XVI. 

Diagram  XVII. 


LIST  OF  DIAGRAMS. 

Page 

Relation  of  increase  in  first  and  total  admissions  to  Michigan  State  Hospi- 
tals to  increase  of  population  of  state  1901-1914 15 

Total  number  and  rate  per  10,000  population  receiving  treatment  at  Mich- 
igan State  Hospitals  during  each  biennial  period  1890-1914 16 

Present  location  and  mental  condition  of  667  patients  10  years  after  their 

discharge  from  Michigan  State  Hospitals 13 

Rate  per  10,000  population  of  the  patients  of  different  nativities  admitted 

to  Michigan  State  Hospitals  Sept.  1,  1913  to  Aug.  31,  1914 23 

Admissions  to  Michigan  State  Hospitals  from  Sept.  1,  1913  to  Aug.  31,  1914. 

Rate  per  10,000  population  urban  and  rural  districts 20 

Forms  of  insanity  admitted  to  Michigan  State  Hospitals  from  urban  and 

rural  communities  Sept.  1,  1913  to  Aug   31,  1914 22 

Sex  in  relation  to  certain  forms  of  insanity.     Admissions  to  Michigan  State 

Hospitals  July  1,  1906  to  June  30,  1912  and  Sept  1,  1913  to  Aug.  31,  1914.  2.5 

Ages  of  patients  admitted  to  Michigan  State  Hospitals,  1890-1912 27 

Extent  of  use  of  alcohol  by  male  patients  admitted  to  Michigan  State 

Hospitals,  Nov.  1,  1913  to  Aug.  31,  1914 30 

Result  of  Wassermann  Tests  on  the  patients  admitted  to  Michigan  State 

Hospitals,  Sept.  1,  1913  to  Aug.  31,  1914 32 

Hereditary  factors  of  4,917  cases  admitted  to  Michigan  State  Hospitals. ...  35 

Comparative  frequency  of  forms  of  insanity  in  admissions  to  Michigan 

State  Hospitals,  Sept.  1,  1913  to  Aug.  31,  1914 38 

Number  per  10,000  that  the  foreign  born  County  Infirmary  inmates  are  of 

the  foreign  born  of  Michigan 69 

Ratio  of  foreign  to  native  born  in  County  Infirmaries  with  distribution  of 

native  born 70 

Distribution  of  ages  of  County  Infirmary  inmates  according  to  sex  and 

mental  status 74 

Previous  admissions  of  County  Infirmary  inmates  according  to  mental 

status 78 

Ratio  per  10,000  population  of  male  and  female  in  County  Infirmaries 

according  to  mental  status 89 


LIST  OF  CHARTS. 

Page 
Chart    1.     Illustrating  the  part  played  by  married  feebleminded  women  in  increasing  the 

number  of  dependent  defectives 100 

Chart    2.     Illustrating  the  inter-relation  of  insanity,  feeblemindedness  and  dependency.. ..  87 

Chart    3.     Illustrating  how-  the  unmarried  feebleminded  women  of  child-bearing  age  increase 

the  numbers  of  dependent  defectives 102 

Chart    4.     Further  illustration  of  the  same .'. .  96 

Chart    5.     Further  illustration  of  the  same 96 

Chart    6.     Case  of  a  woman  prevented  from  further  procreation  by  sterilization •    44 

Chart    7.     Illustrating  sexual  promiscuity  of  a  high-grade  feeble-minded  woman 93 

Chart    8.     Illustrating  inter-relationship  of  insanity,  feeblemindedness  and  dependency 88 

Chart  9.  Illustrating  contribution  of  a  single  family  to  the  population  of  one  County  In- 
firmary    66 

Chart  10.     Illustrating  dependency  in  four  generations 84 

Chart  11.     Illustrating  family  with  more  than  one  feebleminded  member  in  the  County 

Infirmary  at  the  present  time 83 

Chart  12.     Illustrating  family  which  has  already  cost  the  county  for  maintenance  in  the 

County  Infirmary  alone,  over  $17, .500 105 

Chart  13.     Case  of  feebleminded  girl  who  was  allowed  by  the  authorities  to  leave  the  County 

Infirmary  "  to  get  married" 1C3 

Chart  14.     Illustrating  presence  of  chorea  in  several  members  of  the  same  family 80 

Chart  15.     Illustrating  the  inter-relation  of  insanity,  defectiveness  and  dependency 97 

Chart  16.     Illustrating  the  inter-relation  of  sexual  immorality,  criminality,  dependency  and 

defectiveness 82 

Chart  17.     Illustrating  how  desertion  by  wage  earner  may  be  the  immediate  cause  of  the 

dependency  of  his  feebleminded  family 90 

Chart  18.  Illustrating  the  increase  of  the  dependent  defective  class  by  the  married  feeble- 
minded woman 101 

Chart  19.     Illustrating  family  which  became  dependent  upon  the  removal  of  the  wage  earner.  91 

Chart  20.  Illustrating  the  contribution  of  an  unmarried  feebleminded  woman  to  the  depend- 
ent defective  class 98 

Chart  21.     Illustrating  one  family  which  has  had  several  members  in  a  County  Infirmary. ...  85 

Chart  22.     Illustrating  a  result  of  an  illegitimate   cohabiting  of  a  feebleminded  man  and 

woman 94 

Chart  23.  Illustrating  the  menace  to  the  community  of  the  unsegregated  high-grade  feeble- 
minded woman  with  uncontrolled  sexual  impulses 104 

Chart  24.     Illustrating  how  imperfect  segregation  of  the  feebleminded  woman  of  child-bearing 

age  adds  to  the  number  in  the  dependent  defective  class 99 

Chart  25.     Illustrating  feeblemindedness  in  one  family 86 

Chart  26.     Illustrating  how  desertion  by  a  feebleminded  husband  was  the  immediate  cause 

of  the  dependency  of  his  family 92 

Chart  27.  Illustrating  a  case  in  which  sterilization  has  been  resorted  to  in  order  to  prevent 
a    sexually  irresponsible  feebleminded  woman   from  further    increasing    the 

number  of  dependent  defectives 45 

Chart  28.     Illustrating  presence  of  insanity  in  several  generations  of  one  family 36 

Explanatory  table  of  symbols  used  in  all  the  above  charts ll? 

Note.  —  It  must  be  stated  that  these  charts  are  incomplete,  as  they  represent  only  those  individuals 
in  a  family  about  whom  sufficient  information  was  obtained  to  justify  their  classification  as  feeble- 
minded, insane,  etcetera.  This  information,  except  in  rare  cases,  was  not  obtained  by  field  work, 
but  by  careful  questioning  of  the  County  Infirmary  keepers,  the  inmates,  and  occasionally  persons 
outside  of  the  institution.  These  incomplete  charts  are,  therefore,  only  intended  to  indicate  the 
possible  ramifications  of  defectiveness  and  dependency  and  a  field  of  work  wherein  further  Investiga- 
tion would  prove  exceedingly  profitable. 


LIST  OF  TABLES. 


HOSPITALS  FOR  INSANE. 


Table    1.     Showing  number  of  insane  and  distribution  among  institutions  in   Michigan  on  June  30, 

1914. 
Table    2.     Showing  the  relation  of  increase  in  first  and  total  admissions  to  Michigan  State  Hospitals 
Iftiaini  II  .^      to  the  increase  in  total  population  of  State  from  1901-1914. 

Table    3.     Total  number  and  ratio  per  10,000  receiving  treatment  at  Michigan  State  Hospitals  during 
each  biennial  period  1890-1914. 
Nativity  of  patients  admitted  to  the  Michigan  State  Hospitals  for  the  Insanfe  during  the 
year  ending  August  31,  1914. 

Number  per  10,000  of  the  patients  of  different  nationalities  admitted  to  Michigan  State 
Hospitals  Sept.  1,  1913  to  Aug.  31,  1914. 

Nativity  of  parents  of  patients  admitted  to  the  Michigan  State  Hospitals  for  the  Insane 
during  the  year  ending  Aug.  31,  1914. 

Table    7.     Summary  of  Nativity  of  Patients'  Parents. 

Table    8.     Average  yearly  number  of  admissions  to  Michigan  State  Hospitals  by  Counties. 

Table    9.     Place  of  residence  before  admission  to  Michigan  State  Hospitals. 

Table  10.     Sex  in  relation  to  certain  forms  of  insanity.     Admissions  to  Michigan  State  Hospitals  foi 
year  ending  August  31,  1914. 

Table  11.     Forms  of  insanity  in  percentage  relation  to  population. 

Table  12.     Use  of  alcohol  and  drugs. 

Table  13.     Extent  of  use  of  alcohol  by  male  patients  admitted  to  Michigan  State  Hospitals,  Sept.  1 
1913  to  August  31,  1914. 

Table  14.     Results  of  Wassermann  Tests. 

Table  15.     Ages  of  patients  admitted  to  Michigan  State  Hospitals  1890-1912. 

Table  16.     Occupations  in  relation  to  admission. 

Table  17.     Occurrence  and  distribution  of  hereditary  influences  among  4,917  admissions  to  the  Mich- 
igan State  Hospitals. 

Table  18.     Showing  the  fate  of  those  discharged  in  the  biennial  period  ending-June  30,  1904. 


ADRIAN   AND   LANSING  INDUSTRIAL  SCHOOLS. 


Table  19.  Result  of  Binet  Tests  of  the  Boys  in  the  Lansing  Industrial  School. 

Table  20.  Result  of  Binet  Tests  of  the  Girls  in  the  Adrian  Industrial  Home. 

Table  21.  School  Record. 

Table  22.  Facts  in  Regard  to  Physical  Condition. 

Table  23.  Employment  History  of  the  Boys. 

Table  24.  Employment  History  of  the  Girls. 

Table  25.  Delinquent  Record. 

Table  26.  Institutional  Record  Subsequent  to  First  Offense. 

Table  27.  Habits. 

Table  28.  Nativity  of  Inmates. 

Table  29.  Nativity  of  Parents. 

Table  30.  Residential  History.. 

Table  31.  County  of  Commitment. 

Table  32.  Facts  Relating  to  the  Occupations  of  the  Boys'  Fathers. 

Table  33.  Facts  Relating  to  the  Occupations  of  the  Boys'  Mothers. 

Table  34.  Institutional  Record  of  Relatives. 

Table  35.  General  Facts  in  Regard  to  the  Parents. 

Table  36.  Size  of  Fraternities. 

Table  37.  Civil  Status  of  the  Parents. 


8 


COUNTY  INFIRMARIES  OF  THE  STATE. 


Table  38.  Mental  Classification. 

Table  39.  Mental  Classification  by  County. 

Table  40.  Forms  of  Insanity  in  County  Infirmaries. 

Table  41.  Nativity  of  Inmates. 

Table  42.  Number  of  Foreign  Born  in  the  Different  Mental  Classifications  by  County. 

Table  43.  Nativity  of  Parents. 

Table  44.  Age. 

Table  45.  Education  and  Religious  Affiliations. 

Table  46.  Occupation. 

Table  47.  Habits. 

Table  48.  Institutional  History. 

Table  49.  Facts  in  Regard  to  Physical  Condition. 

Table  50.  Civil  Condition. 

Table  51.  Number  of  Children. 

Table  52.  Illegitimacy. 

Table  53.  Births  in  County  Infirmaries. 

Table  54.  Size  of  Fraternities. 

Table  55.  Facts  in  Regard  to  Families. 

Table  56.  Average  Duration  of  Residence  and  Cost  of  Maintenance. 

Table  57.  Cost  of  Maintenance  of  One  Family. 


TO  THE  LEGISLATURE  OF  THE  STATE  OF  MICHIGAN. 

At  the  Legislative  Session  of  1913  there  was  passed  the  following 
Act: 

ACT  NO.  150  PUBLIC  ACTS  1913. 

AN  ACT  to  create  a  commission  to  investigate  the  extent  of  feeble- 
mindedness, epilepsy,  insanity  and  other  conditions  of  mental  defect- 
iveness, and  to  appropriate  the  necessary  moneys  for  the  expense  to 
be  incurred  by  said  commission  in  the  performance  of  its  duties. 

The  People  of  the  State  of  Michigan  enact : 

Section  1,  There  shall  be  a  commission  created  to  investigate  the 
extent  of  feeblemindedness,  epilepsy,  insanity  and  other  conditions  of 
mental  defectiveness  prevalent  in  the  State  of  Michigan,  and  to  make 
a  study  of  the  causes  productive  of  these  conditions. 

Section  2.  This  commission  shall  be  composed  of  the  following  mem- 
bers: The  medical  director  of  the  State  Psychopathic  Hospital  at  the 
University  of  Michigan,  the  Superintendent  of  Public  Instruction,  the 
secretary  of  the  State  Board  of  Health,  and  the  secretary  of  the  State 
Board  of  Correction  and  Charities.  The  medical  director  of  the  State 
Psychopathic  Hospital  is  herewith  made  the  executive  officer  of  the  com- 
mission. 

Section  3.  It  shall  be  the  duty  of  any  and  all  officials  in  charge  of 
any  public,  private,  religious,  charitable,  ])enal  or  correctionary  institu- 
tion in  whose  custody  are  held  individuals  whose  mental  condition  comes 
within  the  scope  of  investigation  of  this  commission  to  furnish  such  in- 
formation as  ma^-  be  desired  by  the  commission  and  to  keep,  during  the 
existence  of  this  commission,  such  records  as  it  may  prescribe. 

Section  4.  This  commission  shall  present  to  the  legislature  of  nine- 
teen hundred  fifteen  a  printed  report  embodying  the  results  of  its  work, 
together  with  such  recommendations  for  the  treatment  and  prevention 
of  these  conditions  as  are  suggested  by  their  investigation. 

Section  5.  The  commission  is  authorized  to  appoint  such  officials  and 
employes  as  it  may  regard  as  necessary  to  carry  on  the  purposes  of  this 
act,  and  such  persons  shall  be  paid  such  salaries  as  may  be  recommended 
by  the  commission  and  approved  by  the  board  of  state  auditors.  These 
salaries  and  all  expenses  of  the  commission,  after  being  duly  certified 
by  the  chairman  or  some  authorized  member  of  the  commission,  shall 
be  paid  from  the  general  fund  of  the  state.  The  members  of  this  com- 
mission shall  receive  no  compensation  for  their  services,  but  their  actual 
and  reasonable  expenses  incurred  in  the  performance  of  their  duties 
shall,  after  approval  by  the  commission,  be  paid  by  the  state  treasurer 
on    the   warrant    of   the    auditor   general,    on    the    rendering   of   their 


10 

.accounts,  out  of  any  moneys  to  the  credit  of  the  general  fund  not  other- 
wise appropriated.  The  above  payments  to  be  made  in  accordance  with 
the  general  accounting  laws  of  the  state. 

This  act  is  ordered  to  take  immediate  effect. 
Approved  May  2,  1913. 

In  pursuance  of  this  Act,  the  commission  was  fonnally  organized  at 
Lansing  on  May  18,  1913.  The  members  of  the  commission  at  that  time 
were  Hon,  Luther  L,  Wright,  Superintendent  of  Public  Instruction ; 
Hon.  Marl  T.  Murray,  Secretary'  of  the  State  Board  of  Correction  and 
Charities ;  Dr.  R.  L.  Dixon,  Secretary  of  the  State  Board  of  Health,  and 
Dr.  Albert  M.  Barrett,  Director  of  the  State  Psychopathic  Hospital.  The 
Commission  elected  as  its  oflScials,  Dr.  Albert  M.  Barrett  to  be  chair- 
man, and  Dr.  R.  L,  Dixon  to  be  secretary. 

On  November  15,  1913,  Hon.  Fred  L.  Keeler  succeeded  Hon.  Luther 
L.  Wright  in  the  office  of  Superintendent  of  Public  Instruction  and 
thus  became  a  memlier  of  the  Commission,  and  on  February  1,  1914. 
Dr.  John  L.  Burkart,  succeeding  Dr.  R.  L.  Dixon  in  the  office  of  Secre- 
tary of  the  State  Board  of  Health,  became  secretary  of  the  Commission. 

The  extent  of  the  investigation  as  assigned  by  this  Act  was  so 
comprehensive  that  the  Commission  was  impressed  by  the  impossibility 
of  conducting  the  work  in  as  detailed  a  manner  as  would  be  desirable 
were  more  time  available.  It  was,  therefore,  decided  to  choose  certain 
lines  of  investigation  which  could  be  done  thoroughly  and  would  furnish 
information  which  would  serve  as  a  basis  for  an  estimate  of  the  entire 
subject. 

The  plan  adopted  was  as  follows: 

1.  An  analysis  of  the  statistics  given  in  periodical  reports  of  the 
various  State  Hospitals  for  the  Insane,  for  a  convenient  number  of 
years,  to  ascertain  facts  relative  to  the  extent  of  insanity  throughout 
the  state,  as  shown  in  the  movement  of  population  of  these  institutions, 
and  such  other  facts  as  might  be  of  value  in  determining  what  condi- 
tions influence  the  occurrence  of  insanity. 

2.  A  co-operative  investigation  by  all  the  State  Institutions  caring 
for  the  insane,  defective  and  delinquent,  carried  through  a  period  of 
one  year,  to  ascertain  (1)  The  influence  of  alcohol  in  the  causation  of 
these  conditions;  (2)  The  occurrence  of  syphilis  as  shown  by  a  system- 
atic use  of  the  Wassermann  Test  on  those  admitted;  (3)  The  prepara- 
tion of  statistics  of  the  current  admissions  for  one  year  relative  to  sex, 
age,  occupation  and  residence;  (4)  A  study  of  the  conditions  of  patients 
discharged  from  the  hospitals  10  years  previously. 

3.  The  determination  of  the  extent  of  feeblemindedness  and  factors 
related  to  it,  among  the  inmates  of  the  State  Industrial  School  for  Boys 
at  Lansing  and  the  Michigan  Industrial  Home  for  Girls  at  Adrian. 

4.  An  examination  of  the  inmates  of  County  Infirmaries  in  the  state 
for  the  determination  of  the  prevalence  among  them  of  feeblemindedness 
and  physical  and  mental  abnormalities. 

The  headquarters  for  the  work  were  located  in  Ann  Arbor.  Dr.  Albert 
M.  Barrett  has  been  in  immediate  supervision  of  the  work. 

The  active  charge  of  the  work  Avas  given  to  a  corps  of  workers,  all 
of  whom  had  had  special  training  for  their  positions.  Harry  W.  Crane, 
Ph.  D.,  was  appointed  chief  investigator  and  was  placed  in  immediate 


II 

charge  of  the  office  and  field  work.  There  were  appointed  as  assistants 
in  special  lines  of  investigation  the  following:  Adele  E.  McKinuie,  A. 
B.,  who  had  previously  been  engaged  in  work  in  Michigan  in  relation 
to  feeblemindedness;  Sarah  D.  MacKay,  A.  M, ;  Pauline  Buck,  A.  B. ; 
and  Charles  Webber. 

Active  field  work  was  begun  in  July,  1913. 

The  work  upon  the  institutions  for  the  insane  has  largely  been  in 
charge  of  Dr.  Crane. 

The  work  among  the  County  Infirmaries  was  done  by  Miss  McKinnie 
and  Dr.  Crane. 

The  investigations  at  the  Industrial  School  for  Boys  at  Lansing  were 
in  charge  of  Miss  MacKay  and  Mr.  Webber, 

The  investigations  at  the  Industrial  Home  for  Girls  at  Adrian  were 
in  charge  of  Miss  MacKay  and  Miss  Buck. 

The  Commission  is  indebted  to  the  officials  of  the  various  state  and 
private  institutions  for  their  cordial  co-operation  in  the  work,  and  to 
the  administrative  officers  in  charge  of  the  County  Infii-maries  for  their 
helpfulness. 

During  the  progress  of  its  work  the  Commission  has  held  meetings  at 
Lansing  and  Ann  Arbor  and  the  minutes  of  these  are  in  charge  of  the 
Secretary  of  the  State  Board  of  Health. 

Respectfully  submitted, 

Albert  M.  Barrett,  M.  D.,  Chairman, 
Director  of  the  State  Psychopathic  Hospital. 

Jno.  L.  Burkart,  M.  D.,  Secretary, 

Secretary  of  the  State  Board  of  Health. 

Fred  L.  Kbeler, 

Superintendent  of  Public  Instruction. 

M.  T.  Murray, 
Secretary  of  the  State  Board  of  Correction  and  Charities. 


12 


CHAPTER  I.— THE  INSANE.* 
Prevalence  of  Insanity. 

In  estimating  the  prevalence  of  insanity  there  are  diflficulties  which 
resiilt  from  the  peculiar  nature  of  the  disorder  and  the  lack  of  definite 
standards  to  determine  what  degree  of  mental  abnormality  should  con- 
stitute insanity.  A  statistical  consideration  of  the  subject  can  at  present 
only  concern  those  who  are  or  have  been  in  institutional  care.  The 
nature  of  insanity  in  its  social  and  legal  relations  makes  it  probable  that 
at  some  time  or  other  most  of  those  who  are  definitely  insane  seek  in- 
stitutional treatment.  The  movement  of  the  population  of  institutions 
for  the  insane  will,  therefore,  furnish  quite  satisfactory  information  re- 
garding the  questions  of  extent  and  increase. 

On  June  30,  1914,  there  were  in  the  special  institutions  of  Michigan 
caring  for  the  insane  7,703  individuals.  Of  this  number  7,030  were  in  the 
seven  State  Hospitals  for  the  Insane,  226  were  in  private  institutions 
and  407  were  in  County  Infirmaries. 

Of  the  entire  population  of  the  state,  27  out  of  each  10,000  were  in 
institutions  for  the  insane.  The  distribution  of  these  among  the  insti- 
tutions of  the  state  is  shown  in  Table  1  of  the  Appendix.  Comparing 
this  rate  with  that  of  the  other  states  throughout  the  country,  we  find 
that  figures  given  in  the  United  States  Census  for  1910  show  that  Michi- 
gan in  that  year  had  a  rate  for  insane  in  institutions  of  23.8  per  10,000 
of  the  population.  This  was  considerably  lower  than  the  rate  of  Massa- 
chusetts with  34.4,  or  New  York  with  31.3.  It  differed  but  slightly  from 
the  states  occupying  a  similar  geographic  position:  in  Illinois,  22.7; 
in  Indiana,  16.7;  in  Wisconsin,  28.2,  and  in  Ohio,  22.2. 

The  ratio  of  the  number  in  institutions  to  the  population  in  any  state 
is  directly  dependent  upon  the  facilities  which  are  present  for  receiving 
those  who  apply  for  admission.  In  making  comparisons  between  varia- 
tions in  the  rate  of  different  states,  it  must  be  borne  in  mind  that  there 
are  considerable  differences  in  the  facilities  which  states  have  for  caring 
for  the  insane. 

A  very  considerable  number  of  insane  are  present  throughout  the  state 
outside  of  institutional  care.  It  is  impossible  to  accurately  estimate 
the  number  of  these  under  the  present  conditions  of  state  supervision. 
Each  year  there  are  discharged  from  the  State  Hospitals  large  numbers 
of  individuals  who  are  not  restored  to  their  normal  mental  state.  Some 
of  these  recover  after  leaving  the  institution,  many  die  and  some  again 
enter  institutional  care.  At  all  times  there  are  in  the  communities 
many  individuals  who  have  been  insane  and  who  do  not  return  to  institu- 
tions. In  order  to  gain  some  idea  as  to  what  becomes  of  those  who  are 
discharged,  a  study  was  made  of  the  fate  of  those  who  were  discharged 
from  the  hospitals  of  Michigan  in  the  four-year  period  ending  June  30, 
1904.  The  results  of  this  investigation  are  embodied  in  Diagram  No. 
HI,  Table  18. 

*  By  Albert  M.  Barrett,  M.  D. 


13 


DIAGRAM  in 


PRESENT   LOCHTION 
/=7ND  MENTAL.  CONDITION  Or 
66~7  PHTIENT^    TEN  VEflF?E> 
nrTER  THEIR  DISCH/IRGE  FROM 
MICHIGAN  STATE  HOSPITALS. 


LIVING 
58.6% 

NO 
DRTfl 
13  6 'X 

DEIRD 

Present 
Pl/=jce  Of  Residence  ' 


NOT  IN  INSTITUTION 
63.9% 


IN  INST. 
35.4% 


Place 
Of  Death 


Present 
Mentrl    Condition 


NORMAL 
45.ZZ 

1^ 

UNBALANCED 
^64  % 

Mental  Condition 
RtTime  Of  DEfTTH 


14 

From  information  concerning  667  cases  discharged  from  the  State 
Hospitals  10  years  ago  it  was  ascertained  that  219,  or  32.8  per  cent,  had 
been  discharged  as  recovered;  350,  or  52.5  per  cent,  as  improved,  and 
80,  or  12.1  per  cent,  as  unimproved.  Of  the  entire  number  discharged 
some  317,  or  47.5  per  cent,  were  readmitted  to  one  of  the  State  Hospitals ; 
many  were  readmitted  and  discharged  several  times;  222  of  this  num- 
ber remained  aw^ay  a  year  or  more;  56  individuals,  or  8.4  per  cent 
of  all  discharged,  had  recurrent  attacks  of  their  disorder  which  wefe 
treated  outside  of  public  institutions. 

Of  the  entire  number  who  were  discharged  185,  or  27.7  per  cent,  had 
died  either  in  or  out  of  an  institution.  There  were  91  individuals  regard- 
ing whom  there  was  no  definite  information  as  to  whether  they  were 
alive  or  had  died.  There  remained  391  individuals  of  whom  129,  or  32.9 
per  cent  of  those  who  were  still  alive,  who  were  living  in  the  institution 
from  which  they  were  previously  discharged,  and  250,  or  63.9  per  cent, 
who  were  living  outside  of  institutional  care.  Of  this  latter  group  22.9 
per  cent  were  still  mentally  abnormal. 

It  can  thus  be  estimated  that  a  very  considerable  number  of  uure- 
covered  insane  continue  to  live  outside  of  institutional  care  for  a  long 
time  after  their  discharge. 


b"- 


Increase  of  Insanity. 

I'  • 

This  phase  of  the  investigation  proceeded  along  two  lines,  il^ii'st,  a 
study  of  the  variations  from  year  to  year  in  the  number  annually  admitted 
to  the  State  Hospitals  for  the  Insane  and,  second,  a  study  of  the  varia- 
tions of  those  yearly  under  treatment. 

In  Diagram  I,  Table  2  of  the  Appendix,  it  can  be  observed  that  the 
total  admissions  have  increased  from  1,115  in  1901  to  1,603  in  1914,  an 
increase  of  43.7  per  cent. 

Between  1901  and  1910  the  admissions  have  increased  from  1,115  in 
1901  to  1,682  in  1910,  an  increase  of  50.8  per  cent. 

Estimated  in  relation  to  the  population  it  was  ascertained  that  the 
rate  of  admissions  per  10,000  of  the  population  in  1901  was  4.5.  This 
increased  in  1910  to  a  rate  of  5.9  per  10,000  of  the  state's  population. 

In  dealing  with  total  admissions  there  are  included  those  who  may  have 
been  readmitted  and  thus  these  figures  do  not  represent  the  actual  in- 
crease in  new  cases  of  insanity.  In  1901  the  first  admissions  (Diagram  I) 
were  793,  or  3.2  per  10,000,  and  in  1910  they  were  1,200,  or  4.3  per  10,000, 
a  rate  which  still  continues  in  1014.  Admissions  of  new  cases  of  in- 
sanity have  increased  62.7  per  cent  between  1901  and  1914,  and  the  new 
admissions  plus  the  readmissions  of  patients  who  were  formerly  under 
treatment  has  increased  43.7  per  cent. 

There  has  also  been  a  marked  increase  in  the  number  of  those  annual- 
ly under  treatment.  This  increase  in  relation  to  the  population  is  shown 
in  Diagram  II  and  Table  3  of  the  Appendix.  In  the  biennial  period 
ending  on  June  30,  1890,  there  were  treated  in  the  Michigan  State  Hos- 
pitals for  the  Insane  3,652  individuals.  This  represented  a  ratio  of 
17.44  to  each  10,000  of  the  population.  In  the  biennial  period  ending 
June  30, 1914,  the  number  treated  was  8,955,  which  was  in  a  ratio  of  30.19 
to  10,000  of  the  population.  The  increase  in  numbers  treated  was  145.2 
per  cent. 

This  analysis  has  shown  that  there  has  been  a  great  increase  both  in 


15 


DIAGRAM     t 


REL/1T/ON  OF  /NCREflSE  /N  F/RST<^  TOT/fL 

/fOn/SS/ONJ  /N  n/CH/6fiA/  SWTE  H03RT/iL5 

TO  /A/Cf?£/^J£  /N  POPUL/7T/0/V  OF  ST/fTE 

/SO/  ro/&/4 


YE/lff 
1901  1902  1903  1904/905  1906 /907 /908 /S09  A»0  191/  19/2  19/J  /9/^ 

l.dCO 

1.100 

300 

TOO 

JOO 

ijdoo 

l,€00 
1.400 
1.200 
1.000 

idodooo 

ZfiOQOOO 
2.4000(0 

i.2oaooo 

2,00O.O0L 

;      !      !.     I      !      ^      1      i      i      i      i 

1 

1 

1 

1 
1 

;  .  !        1        11 

.!_         .]...__ 

'         i  HRST  AOniSS/OA/S                      \ 

1 

!               i 

^_ 

M 

1 

1                i 

1             !             '             i             1             1 

!         1         1 

'         :         i                 1         1 

Jill                                  I                 ■ 

II 

1 



'11!'! 

I 

1 

1          1          I          !         1          1          1 

! 
1 

III  ror/7L  ffOM/s^oNS 

\      \      \      \            (      ' 

ip'"'"^ 

' — 

— ^ 

1 

' 

I 

n 

i 

1 

1 

1 

r-i     ■ 

^''"" 

1        1 

1     i     :     ;     ! 

,          ,          1          1 

1 

PORUL/fr/Of^  OF  JT/fTE 

' 

1 

\                \ 

— 

\ ^r-H 

r^ 

■ 

i 

1 — 

1 

1 

1 

1          ' 

1          t 
1          1 

'     1 

1901  '902  1903  /904  /905  1906  1907 1908  1909/910  1911  1912  19/5  /9/^ 

Y£:ffR 

16 


D/AGRAM  n. 


TOTAL  NUMBER  ^  R/fTE  PER  /QOOO 

POPUL/JT/0/V    RECE/I//A/6  TRE/fTriENT 

ffT  niCH/G/fN  iST/^TE  H0SP/T/7LsS 

DURING    EACH    B/ENN//JL  PERIOD 

IQ30  TO  1914 


YE/iR3 

1890    1631  ld34  1696  1638  1300  I90Z  1904  1906 1908  I9I0  /9/Z  1314 


35 


^10 




7, 

9£/;f/ 

•rr/v: 

8485 

d9SJ 

f?£a 

6€S^5 

'7336 

1 

8027 

r 

76> 

4^47 

4709 

4S68 

P/)riL 

'.NT'S 

€i05 

\ 

d6l9 
4996\ 

«36152 

m9 

\ 

I 

- 

• 

■ 

vi5 


30  ^ 


28  ^ 
20 

I 


aso  lesz  I3S4  lase  i8$d  isoo  isoz  iso4  laos  i908  mo  isiz  /si4 

refifls 


17 

the  admissions  of  the  insane  and  in  those  under  treatment.  Between 
the  census  years  1900  and  1910  the  population  increased  16.1  per  cent 
and  the  number  of  first  admissions  of  insanity  had  increased  51.3  per 
cent  and  the  total  admissions  increased  50.8  per  cent. 

The  character  of  the  population  of  the  state  has  also  changed,  result- 
ing in  an  increase  of  the  rate  per  10,000  of  the  population  from  3.2  per 
10,000  for  first  admissions  in  1901  to  4.3  in  1910.  The  rate  for  1914  re- 
mains about  the  same  as  that  of  1910.  The  rate  of  total  admissions  has 
increased  in  the  same  time  from  4.5  to  5.9  per  10,000.  An  even  greater 
increase  has  occurred  in  those  under  treatment.  In  both  respects  these 
increases  have  been  relatively  much  greater  than  the  increase  of  the  gen- 
eral population. 

Sources  of  Increase. 

To  a  considerable  degree  the  increase  in  the  numbers  of  the  insane 
in  institutions  is  directly  related  to  the  increased  capacity  of  the  Michi- 
gan State  Hospitals  during  recent  years.  It  is  also  probable  that  the 
improvements  in  institutional  administration  and  a  higher  intelligence 
on  the  part  of  the  people  of  the  state  h.ave  lessened  the  aversion  which 
has  always  been  present  toward  placing  insane  relatives  in  institutional 
care.  ^ 

In  order  to  ascertain  what  conditions  and  influences  may  be  present 
in  Michigan,  making  it  necessary  to  continually  increase  the  capacity  of 
the  State  Hospitals  for  the  Insane,  the  Commission  undertook  an  investi- 
gation of  certain  factors  which  experience  has  shown  are  of  importance 
in  their  association  with  insanity'.  These  included  the  distribution  of 
insanity  in  Michigan  in  relation  to  locality  and  to  the  foreign  population, 
and  the  influence  of  sex,  age,  occupation,  alcohol  and  drugs,  syphilis  and 
heredity. . 

Influence  of  Locality. 

Map  I  shows  the  ratio  of  admissions  to  the  Michigan  State  Hospitals 
for  the  Insane  for  a  period  of  10  years,  from  the  different  counties  for 
each  10,000  of  their  population. 

There  were  20  counties  averaging  less  than  four  admissions  per  10,000 
population,  38  averaging  four  to  six  admissions,  18  averaging  six  to 
eight  and  seven  more  than  eight.  The  highest  was  Luce  county,  which 
had  a  ratio  of  15.6  per  10,000  of  its  population. 

There  is  nothing  in  common  in  the  location  of  the  counties  having  high 
ratios  except  that  relatively  the  counties  of  the  upper  peninsula  have 
higher  averages  than  those  of  the  lower.  It  is  not  a  matter  of  population 
as  the  four  counties  having  the  largest  populations  have  wide  differences 
in  their  ratios.  Wayne  and  Saginaw  Counties  have  ratios  of  four  to 
six.  Kent  County  has  a  ratio  of  six  to  eight  and  Bav  County  of  six  per 
10,000.  This  latter  county  has  a  population  of  68,238  but  a  ratio  of  2.6, 
while  Eaton  Countv  with  a  population  of  30,499  has  a  ratio  of  6.1  per 
10,000. 

It  is  important  to  note  that  all  counties  in  which  are  located  the 
larger  State  Hospitals  for  the  Insane  have  high  ratios.  There  is  no 
reason  for  believing  that  conditions  which  may  be  productive  of  insanity 
are  more  prevalent  in  these  counties  than  in  others.  These  factors  are 
certainly  less  than  in  counties  of  largest  population.  It  seems  probable 
3 


18 

that  in  these  counties  a  smaller  number  of  insane  avoid  commitment  to 
institutions  than  in  other  counties.  This  may  be  due  to  familiarity  with 
the  administration  and  benefits  of  institutional  treatment  and  a  more 
wide-spread  interest  in  the  care  of  the  insane  resulting  from  the  proximity 
of  a  State  Hospital  and  consequently  less  reserve  in  placing  those  who 
are  insane  under  treatment. 

MAP  I. 


DOMINION     OF    CANADA 


6-e  PER  lao 
B  OVCR  epE.R.  \e 

O     QQ  OEHCrrbe  erfrTE    INSTl]tlT10rtS. 


I  LLI  N  0   IS 


It  seems  warrantable  to  conclude  that  the  ratios  for  the  commitments 
from  these  counties  are  a  truer  index  of  the  actual  prevalence  of  in- 
sanity than  in  counties  where  the  ratios  are  smaller.  The  high  average 
of  the  counties  around  Luce  county  is  probably  due  to  their  high  per- 
centage of  foreign  population  and  their  close  proximity  to  an  institu- 


19 

tion.  The  high  ratio  for  Ontonagon  county  it  seems  impossible  to  explain 
from  any  information  available. 

It  has  not  been  easy  to  closely  correlate  the  distribution  of  admissions 
to  the  size  of  the  foreign  population  in  any  locality.  Map  II.  Some  coun- 
ties having  high  ratios  of  foreign  population  do  not  have  excessive  ratios 
of  admission.    In  Gogebic  county  there  is  a  high  proportion  of  foreign 

MAPH 


I  LLI  N  0   IS 


born  but  a  low  ratio  of  commitments.     As  a  rule  the  counties  of  the 
upper  peninsula  which  have  high  ratios  of  commitments  also  have  rela 
tively  large  proportions  of  foreigners  in  their  population. 

The  need  of  placing  those  who  are  insane  in  institutions  is  always 
greater  in  localities  which  have  more  complex  social  organizations  and 


20 


DIAGRAM  V. 


Admissions  toniCHIGAN 
STATE  HOSPITALS  from 
Sept  1. 1  SI 3  to  Aug.  J/,  IQI4.  Rate 
per  10,000  population.  Urban 
and  Rural  districts. 


I  I 

i 


J 


oveR 

IOO.OOO 


sS/.OOO 

10,000 


PI 


^^ 


v5.^^^  2,0OO 

POPUL  AT/ON 


PUPAL 


U/VD£/? 

2.000 


21 

it  is  probable  that,  in  districts  where  the  industries  do  not  demand  high 
degrees  of  mental  responsibility  or  where  the  population  is  widely  scat- 
tered, there  is  less  occasion  for  the  elimination  from  among  them  of  those 
who  are  insane. 

The  relation  of  admissions  to  institutions  to  the  density  of  popula- 
tion is  given  in  Diagram  V  and  Table  9.  It  can  be  observed  that  the 
highest  averages  of  admissions  in  relation  to  population  come  from 
districts  having  populations  of  from  2,000  to  5,000;  and  the  lowest  are 
from  strictly  rural  populations.  In  relation  with  this  is  the  fact  that 
52.8  jjer  cent  of  the  population  of  Michigan  is  located  in  districts  hav- 
ing a  population  of  less  than  2,500. 

The  influence  of  density  of  population  becomes  much  more  important 
when  considered  in  relation  to  the  prevalence  of  certain  types  of  in- 
sanity.    This  is  shown  in  Diagram  VI  and  Table  9. 

Among  the  admissions  to  the  Michigan  State  Hospitals  during  the 
year  ending  June  30,  1914,  cities  of  10,000  or  over  contributed  68.5  per 
cent  of  the  cases  of  insanity  due  to  syphilis  and  66.6  per  cent  of  those 
resulting  from  alcoholism  or  drugs.  Both  of  these  causes  exert  their 
influence  upon  the  individual  from  outside  and  are  peculiarly  related 
to  environment. 

On  the  other  hand,  certain  forms  of  insanity  seem  to  develop  inde- 
pendent of  environment  and  external  factors,  the  chief  influence  being 
a  defective  physical  or  nervous  stock  or  abnormal  inheritances.  In 
these  cases  the  reasons  for  the  development  of  the  disease  are  in  the 
individual's  personal  peculiarities  of  mind  or  body.  It  is  to  be  expected 
that  such  types  of  individuals  tend  to  be  where  there  is  a  less  active 
struggle.  We  thus  find  that  55.4  per  cent  of  all  cases  of  epilepsy  and 
feeblemindedness  and  58.6  per  cent  of  all  cases  of  manic  depressive  in- 
sanity admitted  to  the  Michigan  State  Hospitals  come  from  districts 
having  a  population  less  than  10,000  and  42.17  per  cent  of  cases  of 
epilepsy  and  feeblemindedness  and  43.5  per  cent  of  cases  of  manic  depres- 
sive insanity  come  from  districts  of  2,000  or  less.  Dementia  praecox  is 
slightly  more  prevalent  among  admissions  from  the  smaller  districts. 
The  same  is  true  of  senile  dementia,  or  the  insanity  of  old  age,  41.9  per 
cent  of  the  admissions  for  this  disorder  coming  from  districts  having  a 
population  of  less  than  2,000. 

Influence  of  Foreign  Population. 

In  most  investigations  into  social  problems  there  soon  becomes  evident 
the  influence  which  foreign  immigration  has  had  in  modifying  conditions 
and  bringing  into  the  social  life  inheritances  and  customs  which  alter 
for  good  or  evil  the  health  of  the  community.  The  material  which  forms 
the  basis  for  the  conclusions  regarding  this  phase  of  the  Commission's 
investigations  was  obtained  from  an  analysis  of  information  regarding 
the  nativity  of  1,773  individuals  admitted  to  the  Michigan  State  Hospi- 
tals for  the  Insane  during  the  year  ending  August  31,  1914.  Table  4 
of  the  Appendix  gives  the  distribution  according  to  country  or  state  of 
birth  of  all  who  were  admitted  to  the  Michigan  State  Hospitals  for  the 
Insane  during  the  year  ending  August  31,  1914. 

Of  all  admissions  regarding  which  information  was  obtained  535  were 
foreign  bom  and  1,199  were  bom  in  the  United  States.  In  Table  5  is 
shown  the  ratio  per  10,000  of  each  nationality  contributing  to  the  ad- 


22 


DIAGRAM    VI. 


Forms  of  INSANITY 
odmmed  to  MICHIGAN  STATE 
HOSPIWLS  from  Urban  and 
Rural  Communities  Sept  I IQ 1 5 
to  Aug.3U^I4, 

Forms  of/n^an/yy^ 
Cerebral  SyphU/s 


PERCENT 

10     20    30     40    ^O   eo    70    80    30    lOO 


Alcohol  "¥  Dru^sS 


Demenr/a  Praecox 


Eplleptici-De^cflvG\ 


nan/c  Depre^^ji/e 


'Senl/e  Dement/c 


// /  /  \/  / 


y//. 


y///.// 
y/ //■■//, 


C /ties  Oyer 

/oo,ooo 

^7\ 


,5 1. OOP 
/ 0,000 


IQOOO 
^000 


^5.000 
2,000 


2.000 
AndUrx^er 


Resiotence 
Un/fnotvn 


23 


DIAGRAM   W 


Rate  per  /QOOO  popu/af/on  of  the 
Paf/enfs  of  d/ffcrenf  /\/ar/^/f/es5  Qcfm/tfed 
To  /^/c/i/(^an  6rafe  P/o^sp/ra/s.  Sepf  /.  /&/3 
to  /fug.^l/^/^. 


/JU5TRIf1 


FR/INCE 


BELGlun 


C/lNflD/l 


DENtl/JPK 


GERMANY 


HOLL/JND 


HUNG/1RY 


J. 


ENG-^W/fLES 


FJNUJND 


/REL/JND 


IT/1LY 


0    ^    10    k5  ao 


AtORW/JY 


0     ^     lO     IS    20 


RUSSl/fjPOLmO 


smrZERUND 


NJfTll/E-BORN 


FOREIGN'BORN 


O     ^     10    16    20 


24 

missions  to  the  Michigan  State  Hospitals  for  one  year,  based  upon  the 
number  of  that  nationality  living  in  Michigan,  The  figures  given  in 
this  table  are  shown  graphically  in  Diagram  IV.  Among  the  admissions 
the  native  born  have  a  ratio  of  5.4  per  10,000  and  the  foreign  born  a 
ratio  of  8.0  per  10,000. 

The  highest  rate  is  that  for  those  born  in  Russia  including  Poland. 
This  amounts  to  19.2  per  10,000  of  those  nationalities  in  Michigan. 
Among  the  total  foreign  born  in  Michigan  natives  of  Russia  and  Poland 
constitute  G.3  per  cent.  The  nationalities  which  contribute  more  than 
the  average  admission  rate  for  all  foreign  born  are  Switzerland,  Finland, 
France,  Scotland  and  Norway,  Switzerland  constitutes  only  0.40  per 
cent  of  the  total  foreign  born  population  but  has  an  admission  rate  of 
14,3  per  10,000  of  that  nationality  living  in  the  state,  Finland  consti- 
tutes 5,2  per  cent  of  the  foreign  born  in  Michigan  and  has  an  admission 
rate  of  1.3,7  per  10,000,  France  constitutes  0,4  per  cent  of  the  foreign 
born  in  Michigan  and  has  a  rate  of  12  per  10,000,  Natives  of  Scotland 
furnish  1,G  per  cent  of  the  foreign  born  population  but  have  a  rate  of  12 
per  10,000,  Norwav  constitutes  1.1  per  cent  of  the  foreign  bom  and  has 
a  rate  of  9.1  per  10,000. 

These  figures  are  important  only  where  there  is  any  considerable  num- 
ber of  that  nationality  present  in  the  state  and  its  admissions  form  a 
relatively  large  numlier  among  the  foreign  admissions.  In  comparison 
with  others  in  this  group  Switzerland,  France  and  Norway  have  only 
a  few  admissions  to  the  hospitals  and  each  forms  only  a  small  propor- 
tion of  the  foreign  born  in  Michigan. 

Tables  6  and  7  give  the  number  of  native  born  among  the  admissions 
whose  parents  were  bom  in  various  foreign  countries.  The  rate  per 
10,000  for  admissions  of  those  both  of  whose  parents  were  foreign  bora 
was  12.8,  while  for  those  whose  parents  were  both  born  in  this  country 
the  rate  was  only  4.8  per  10,000. 

The  distribution  of  the  foreign  born  among  the  counties  of  Michigan 
is  shown  in  Map  II,  (See  page  19),  The  largest  relative  numbers  of  for- 
bom  are  found  in  the  counties  of  the  upper  peninsula  and  the  smallest 
among  the  counties  of  the  lower  central  portion  of  the  state. 

It  is  shown  in  the  analysis  that  the  foreign  born  in  Michigan  have  a 
higher  frequency  of  admission  according  to  their  number  in  Michigan 
than  have  those  of  native  birth  and  that  the  ratio  per  10,000  for  those 
who  are  of  native  birth  but  of  foreign  parentage  is  1C6  per  cent  greater 
than  that  of  those  whose  parents  were  born  in  this  country. 

It  is  also  shown  that  certain  nationalities  have  a  greater  liability  than 
others  to  be  admitted  to  insane  hospitals.  This  is  notably  the  case  among 
the  natives  of  Russia  including  Poland,  Finland  and  Ireland,  The  only 
foreign  nationalities  in  Michigan  having  a  lower  admission  rate  than 
that  of  the  native  bom  are  Denmark  and  Italy. 

There  is  no  doubt  but  that  foreign  immigration  has  had  a  considerable 
influence  in  increasing  the  number  of  admissions  to  the  State  Hospitals 
for  the  Insane  in  Michigan, 

Influence  of  Sex. 

From  whatever  standpoint  one  may  analyze  the  relative  frequency  of 
insanity  as  a  whole  among  the  sexes,  it  is  always  found  that  the  rate  is 
higher  among  the  males  than  the  females.    From  figures  obtained  from 


25 


DIAGRAM  Vn. 


Sex  in  relation  to  certain 
formd  of  Insanity.  Admissions  to 
MICHIGAN  STATE  HOSPITALS 
July  11306  to  June  dO.  1912  and 
Sept  L  I9I^>  to  A  ug.OI.  131  A-. 


O     ZOO  400  €00  800  /flOO  idOO  liMO  IfiOO  (poo  2.000 


Hanic  Depress/ /G 


Dementia  Praecox 


Cerebral  6yphili^ 


\5er?//e  Dement/a 


A/coho/^  Drug 


HALE 


mmmmsssm  | 


FEHALE 


26 

the  13th  United  States  Census  it  may  be  ascertained  that  for  all  of  the 
insane  in  institutions  in  1910  the  rate  per  10,000  of  the  population  was 
20.8  for  males  and  19.9  for  females.  The  same  relative  differences  exist 
for  all  of  the  insane  in  this  country  who  were  admitted  in  the  year  1910. 
For  males  the  rate  of  admission  was  7.2  and  for  females  5.9. 

In  Michigan  the  rate  for  the  males  admitted  during  the  year  1892  was 

6.6  per  10,000  and  for  the  females  6.1.    In  1910  the  male  admission  was 

9.7  per  10,000  population  and  the  female  7.7.  In  this  interval  the  rela- 
tive differences  between  the  rates  for  males  and  females  was  still  further 
increased. 

There  are  certain  forms  of  insanity  in  which  the  sexes  are  present 
in  very  unequal  proportions.  Diagram  VII,  Table  10.  Among  2,009 
cases  of  manic  depressive  insanity  females  exceeded  the  males  in  the 
ratio  of  1.3  to  1.  In  dementia  praecox  the  males  exceeded  the  females 
in  the  ratio  of  1.5  to  1.  In  cerebral  syphilis,  including  paresis,  the  males 
far  outnumber  the  females,  the  ratio  being  3.9  to  1.  In  senile  dementia 
the  ratio  of  males  to  females  is  1.6  to  1.  In  insanity  due  to  alcohol  and 
drugs  males  exceeded  females  in  the  ratio  of  6.5  to  1. 

Influence  of  Age. 

The  relation  of  age  to  the  occurrence  of  insanity  was  studied  from  an 
analysis  of  the  ages  of  about  20,000  admissions  to  the  Michigan  State 
Hospitals  during  the  period  1890  to  1912.  The  result  of  this  is  given 
in  Diagram  YIII,  and  Table  15  of  the  Appendix. 

A  very  small  proportion,  0.42  per  cent  of  all  admissions,  are  admitted 
below  the  age  of  15.  Between  the  ages  of  15  and  19,  the  admissions 
number  4.1  per  cent.  The  admissions  between  the  ages  20  and  29 
amount  to  19.3  per  cent.  The  age  of  the  largest  number  admitted  is 
between  30  and  39,  when  22.6  per  cent  are  admitted.  After  this  age 
there  is  a  continued  decrease.  Between  40  and  49  the  admissions 
amounted  to  20.1  per  cent.  In  the  period  between  50  and  59  there  were 
admitted  13.6  per  cent  and  from  60  to  69  they  amounted  to  9.3  per  cent. 
After  the  age  of  70  the  number  admitted  was  7.3  per  cent  of  the  total. 

It  was  found  that  relatively  the  greatest  number  of  admissions  occur- 
red during  the  adult  period  of  life  and  the  largest  number  were  admitted 
in  the  decade  between  30  and  40.  The  relative  per  cents  in  Michigan 
agree  with  those  throughout  the  country.  From  the  figures  given  in  the 
last  census  report  relative  to  the  age  of  56,182  insane  individuals  admitted 
in  the  year  1910  to  hospitals  of  the  United  States,  it  may  be  ascertained 
that  the  age  period  of  greatest  frequency  of  admission  is  between  30  and 
40,  and  at  all  age  periods  the  relative  proportions  found  to  exist  in  Michi- 
gan are  maintained. 

In  order  to  determine  whether  there  was  any  change  in  the  relation 
of  age  to  admission,  a  comparison  was  made  between  the  ages  of  ad- 
mission in  1890-92  and  1910-12.  In  the  former  period  the  age  of  the 
greatest  frequency  was  25  to  30  and  in  the  latter  period  this  had  changed 
to  35  to  40. 

In  1892  the  age  of  greatest  frequency  among  males  was  between  25 
and  30,  and  among  females  was  between  30  and  35.  In  1912  more  males 
were  admitted  in  the  period  35  to  40  and  the  age  for  the  greatest  fre- 
quency among  the  females  was  the  same  as  in  1892. 


27 


DIAGRAM  'vnr. 


HGES   or  P/^TJEINTS 

/ADMITTED  TO  M/CHIG/9N 

STflTE  H03f=^ITnLS. 

/ 6  90'/ 9 1  EL. 


Admitted  Durinq  IZ  Year  Period. 


o^. 


O      10    ZO    30  40    so    60    70    80 
/^GE  IN    YEARS 


90 


o 
too 


Admitted  During  I89L    Admitted  During  19)2.. 


~ 

r  '■■ 

— 1 



— 1 

7 

n 

Tt\ 

^- 

h 

10- 

— 

^ 

5 



^ 

k'^- 

~" 

"  "" 

~ 

_ 

rf 

h 

m 

,- 

- 

kl 

•J  r 

* 

tt^ 

— 

'<lo- 

1 

_ 

^0- 

"' 

"" 

"■ 

Q 

M 

f^ 

ft- 

— 

- 

10 1 

- 

,5 

— 1 

5  \ 

i- 

\ 

— 1 

n , 

_ 

^  _ 

— 

~ 

IlEA'AU'^ 


zniz^l 


l^^JL 


■10 

■  s 

kj 

^\ 

-10 
-5 


0 ,  10    ZO    30    40   SO    60    lO    80   90  lOO 
ffGE  IN  YEf^RS 


0     10     ZO   30    40     £0   60    70    60    90 
AGE  IN    YE/^P5 


\0 

lOO 


28 

Comparison  as  to  differences  in  age  frequency  between  the  admissions 
of  1892  and  1912  show  that  there  is  a  decrease  in  the  admissions  of  the 
cases  of  insanity  developing  before  the  age  of  50  and  a  marked  in- 
crease of  those  above  50  years  of  age.  In  1892  the  admissions  after 
the  age  of  50  were  30.5  per  cent  of  all  admitted  and  in  1912  they  amount- 
ed to  39.4  per  cent.  This  was  true  for  both  males  and  females  and  for 
'first  admissions  and  total  admissions. 

From  this  analysis,  one  must  conclude  that  insanity  is  most  liable  to 
occur  in  either  males  or  females  between  the  ages  of  .30  and  40  and  that 
this  has  shown  no  change  in  the  past  22  years.  There  has  been  a  con- 
siderable increase  in  insanity  which  develops  in  later  adult  and  early 
senile  years. 

Influence  of  Occupation. 

In  Table  IG  is  given  the  distribution  of  the  admissions  among  various 
divisions  of  occupations.  The  lack  of  auj'  information  regarding  the 
proportion  of  the  general  population  engaged  in  these  occupations  makes 
it  impossible  to  draw  any  conclusions  that  may  be  of  value. 

Influence  of  Alcohol. 

The  Commission  is  able  in  this  report  to  consider  the  influence  of 
alcohol  only  as  it  is  a  cause  or  factor  in  the  production  of  the  cases 
of  insanity  which  are  admitted  to  the  State  Hospitals  for  the  Insane. 
It  should  not  escape  attention  that  the  numerous  cases  of  alcoholic 
intoxication  and  delirium  tremens,  which  are  problems  of  increasing  im- 
portance in  all  communities  of  the  state,  are  also  due  to  the  effect  of 
alcohol  upon  the  nervous  system.  All  are  mental  disturbances  due  to 
.alcohol  and  the  cases  of  insanity  admitted  to  the  State  Hospitals  give 
only  a  slight  suggestion  of  its  importance  in  its  relation  to  the  health 
of  the  individuals  and  the  state.  No  thorough  study  of  its  influence 
could  warrant  any  other  conclusion  than  that  it  is  the  most-  active  in- 
fluence present  in  our  social  life  for  the  production  of  poverty,  crim- 
inality and  physical  and  nervous  degenerac3\ 

Michigan  has  no  institution  for  the  special  treatment  of  alcoholic 
habits  or  inebriety.  A  statute  enacted  by  the  legislature  of  1913  makes 
it  possible  for  this  class  to  enter  the  State  Hospitals  for  treatment,  but 
only  a  small  number  have  been  admitted  under  this  act.  In  the  vicinity 
of  Detroit  two  large  hospitals,  tlie  Wayne  County  Hospital  and  St. 
Joseph's  Eetreat,  annually  treat  a  considerable  number  of  acute  and 
periodic  forms  of  alcoholic  intoxication.  Only  the  more  prolonged  forms 
of  alcoholic  mental  disorders  and  definitely  insane  conditions  due  to 
alcohol  are  treated  in  any  numbers  in  the  State  Hospitals  for  the  Insane. 
Only  exceptionally  are  cases  of  delirium  tremens  admitted. 

Alcohol  was  the  direct  cause  of  the  insanity  of  150  individuals  who  were 
admitted  to  the  Michigan  State  Hospitals  in  the  year  1913-14.  Alco- 
holic insanity  constituted  8.4  per  cent  of  1,773  patients  admitted  during 
that  period.  This  form  of  insanity  was  6.5  times  more  frequent  among 
males  than  females.  Diagram  VII.  (See  page  25).  It  was  by  no 
means  rare  g.mong  females,  as  13.2  per  cent  of  all  cases  of  alcoholic  insan- 
ity considered  were  of  this  sex. 

The  greater  proportion  of  alcoholic  insanity  comes  from  cities  of  larger 
population.     Those  having  a  population  of  10,000  or  more  furnish  G6.6 


29 

per  cent  of  the  cases  of  insanity  due  to  alcohol  or  drugs.    Diagram  VI. 
(See  page  22). 

The  indirect  influence  of  alcohol  is  shown  in  the  occurrence  of  alcohol- 
ism of  more  than  ordinary  degree  among  the  ancestors  and  families  of 
9.9  per  cent  of  all  cases  of  insanitj^  admitted  for  treatment. 

The  comparative  frequency  of  insanity  due  to  alcohol  is  considerably 
less  in  Michigan  than  in  those  states  in  which  the  population  is  largely 
centered  in  cities.  Alcohol  was  given  as  the  sole  cause  in  13.9  per  cent 
of  the  cases  of  insanity  admitted  to  the  State  Hospitals  for  the  Insane 
in  Massachusetts  in  1914,  and  in  New  York  15.1  per  cent  of  the  admis- 
sions were  due  to  alcohol. 

There  has  been  no  marked  increase  of  alcoholic  insanity  in  Michigan 
during  recent  years,  but  its  annual  contribution  does  not  lessen  to  any 
considerable  degree.  As  regards  the  general  use  of  alcohol  among  those 
admitted  to  the  insane  hospitals,  an  investigation  of  the  habits  of  846 
males  admitted  to  the  Michigan  State  Hospitals  for  the  period  of  one 
year  showed  that  62  per  cent  were  users  of  alcoholic  drinks  and  25.7  per 
cent  were  total  abstainers.    Diagram  IX,  Tables  12  and  13. 

Of  those  who  drank,  23.8  per  cent  were  classed  as  occasional  moder- 
ate drinkers;  7  per  cent  drank  steadily  in  moderate  amounts;  3.2  per 
cent  drank  steadily,  but  occasionally  to  an  excessive  degree;  9.7  per  cent 
could  be  classed  as  occasional  excessive  or  periodic  drinkers,  and  18.3 
per  cent  drank  steadily  in  excessive  amounts.  Of  all  those  who  used 
alcoholic  drinks,  31.2  per  cent  were  more  than  moderate  in  their  use. 

When  considered  in  relation  to  various  types  of  insanity,  the  use  of 
alcohol  to  more  than  a  moderate  degree  was  present  in  alcoholic  insanity, 
cerebral  syphilis  including  paresis,  and  senile  dementia.  Among  other 
forms  its  use  was  about  equally  distributed. 

Influence  of  Drugs. 

There  exists  a  widespread  impression,  Avhich  is  substantiated  by  the 
experiences  of  police  courts  in  the  larger  cities,  that  addiction  to  harmful 
drugs  is  of  great  frequency  and  continually  increasing.  The  investiga- 
tions that  this  Commission  was  able  to  make  in  relation  to  the  char- 
acter of  the  admissions  to  the  State  Hospitals  showed  that  relatively  few 
cases  of  mental  disorders  due  to  drugs  werie  annually  treated.  In  1914 
about  1.7  per  cent  of  the  admissions  were  due  to  mental  disorders  re- 
sulting from  the  use  of  drugs.  This  gives  no  adequate  information  re- 
garding their  use  among  the  general  population. 

While  drug  habits  lead  to  varying  degrees  of  nervous  and  mental  im- 
pairment, only  exceptionally  do  they  result  in  forms  of  insanity  which 
make  it  necessary  for  their  commitment  by  the  authority  of  the  courts. 

As  a  rule,  individuals  of  this  class  are  disinclined  to  voluntarily  seek 
treatment  in  institutions  where  they  must  be  eared  for  among  the  in- 
sane. The  greater  number  of  those  who  come  into  the  State  Hospitals 
because  of  the  use  of  drugs  are  individuals  who,  apart  from  the  effects 
of  the  drug,  are  mentally  abnormal  and  belong  in  the  group  of  the 
psychoneurotics. 

The  drugs  most  frequently  used  were  preparations  of  opium.  Usually 
it  was  morphine  and  more  rarely  heroin.  Instances  of  mental  disorders 
due  to  cocaine  have  been  extremely  rare.  It  was  more  common  to  find 
those  with  drug  habits  using  both  opium  preparations  and  cocaine. 


30 


DIAGRAM   K. 


EXTENT  or  USE  OF  RLCOHOL 
BY  MALE  PATIENTS   ADMITTED  TO 
MICHIGAN  STHTE  HOSPITALS. 
NOVEMBER  1. 1913  TO  AUGUST  31. 1914. 


31 

It  is  of  importance  to  note  that  in  a  majority  of  instances  the  drug 
habit  was  started  through  introduction  to  the  drug  by  a  physician  in 
the  course  of  medical   or  surgical  treatment. 

In  spite  of  the  regulations  relative  to  the  selling  of  habit  forming 
drugs,  patients  uniformly  tell  of  having  no  difficulty  in  obtaining  the 
drug  from  drug  stores. 

Influence  of  Syphilis. 

More  than  one-eighth  of  the  cases  of  insanity  annually  admitted  for 
treatment  to  Michigan  State  Hospitals  for  the  Insane  are  directly  caused 
by  syphilis. 

Syphilis  is  the  cause  of  every  case  of  paresis,  the  most  severe  and  uni- 
formly fatal  form  of  mental  disorder  which  is  treated  in  any  consider- 
able number  in  hospitals  for  the  insane.  In  addition  to  paresis  there 
are  annually  treated  a  small  number  of  cases  of  insanity  which  are  due 
to  various  other  severe  pathological  changes  in  the  brain  produced  by 
syphilis. 

In  the  year  1913-1914  insanity  resulting  from  syphilis  constituted  12.9 
per  cent  of  all  cases  admitted  to  the  Michigan  State  Hospitals  and  form- 
ed the  third  group  in  point  of  largest  numbers.  It  was  the  direct  cause 
of  insanity  in  17.5  per  cent  of  all  males  and  6.65  per  cent  of  all  females 
admitted. 

In  order  to  ascertain  the  general  prevalence  of  syphilis  among  the  in- 
sane in  institutions  a  systematic  use  of  Wassermann's  Test  was  made 
in  1,546  patients  admitted  during  the  year  1913-1914.  The  results  of  this 
are  shown  in  Diagram  X  and  Table  14  of  the  Appendix. 

In  21.6  per  cent  of  940  males  who  were  tested,  there  were  obtained 
positive  reactions  and  an  additional  3.6  per  cent  were  strongly  sug- 
gestive of  the  presence  of  syphilis.  In  74.8  per  cent  of  the  males  the 
test  was  negative.  Among  606  females  who  were  tested,  positive  re- 
actions were  obtained  in  12.7  per  cent.  Of  all  admissions  18.1  per  cent 
gave  positive  reactions,  4.17  per  cent  were  questionable  and  77.2  per 
cent  were  negative  in  their  reactions. 

It  is  thus  shown  that  besides  those  admitted  for  paresis  and  cerebral 
syphilis  there  was  a  considerable  percentage  of  others  who  have  syphilis 
although  they  may  be  admitted  with  some  other  type  of  mental  disorder. 

During  the  past  24  years  the  proportion  of  cases  of  paresis  has  varied 
among  the  males  admitted  to  the  State  Hospitals  for  the  Insane  from 
11.1  per  cent  to  17.5  per  cent  and  among  the  females  from  2.1  per  cent 
to  6  per  cent.  Within  recent  years  the  disease  has  become  more  frequent 
among  the  total  number  of  females  annually  admitted. 

In  its  indirect  effects  syphilis  is  of  extreme  importance.  Not  only  is 
it  responsible  for  the  insanity  of  the  patient,  but  a  high  percentage  of 
the  conjugal  mates  become  infected  by  the  patient  or  are  the  source  of 
his  infection.  It  is  also  responsible  for  the  reduction  of  the  birth  rate 
in  the  families  of  the  paretic  and  for  a  severe  impairment  of  the  nervous 
and  physical  health  of  their  descendants. 

Through  the  kindness  of  Dr.  R.  H.  Haskell  of  the  State  Psychopathic 
Hospital  at  Ann  Arbor,  the  Commission  is  able  to  report  the  results  of  a 


32 


DIAGRAM  X. 


RESULTS  or  WflSSERM/^N 
TESTS  ON  P/IT/ENTS  ADMITTED  TO 
MICHIGfIN  STflTE  HOSf=>IT/QLS 
SEP,  L 1913  TO  /quo.  3  A  f9l4. 


MHLE 


FEMALE 


TOTfIL 


Percent  Of  P^t/ents    Tested 

10      ZO     30     40     SO     60     70     QO     90    100 


1 


\A//935Ef?M^N  Reliction 

POSITIVE  NEGATIVE 


QUE^TIONHBLE 


33 

study  made  by  him  on  the  influence  of  syphilis  and  paresis  upon  the  con- 
jugal mate  and  children  of  the  infected  individual.    Dr.  Haskell  says: 

Among  53  married  individuals  who  were  diseased  with  paresis  there  were 
17  or  32  per  cent  of  instances  in  which  the  wife  or  husband  was  infected  with 
syphilis  as  shown  by  the  Wassermann  Test.  This  figure,  though  high,  must 
not  be  taken  as  representing  the  whole  situation.  One  wife  acknowledging 
a  severe  infection  had  had  careful  treatment  and  presented  a  negative  reaction 
at  this  time.  The  first  wife  of  a  patient,  whose  second  wife  now  has  a  strongly 
positive  reaction,  herself  died  of  syphilitic  disease.  In  the  case  of  two  female 
paretics,  one  husband  also  has  paresis  and  the  other  died  recently  of  locomotor 
ataxia.  Since  both  of  these  diseases  are  syphilitic  in  nature  they  should  be 
added  to  the  total.  There  are  numerous  other  factors  which  might  tend  to 
swell  this  figure  but  adding  only  these  definite  cases  one  finds  in  55  paretic 
patients  a  total  of  21  mates  infected  with  syphiUs. 

Separated  into  sexes,  we  find  that  in  .49  cases  where  the  husband  is  paretic, 
17  wives  are  infected  with  syphilis;  in  six  cases  where  the  wife  is  paretic,  the 
husband  is  infected  four  times. 

While  these  figures  are  high,  they  are  not  greatly  higher  than  other  investi- 
gators have  found  and  as  already  suggested  probably  underestimate  rather  than 
exaggerate  the  true  situation.  In  one  study,  that  of  Plant  and  Goering,  it  was 
found  that  the  other  mate  showed  a  positive  reaction  in  32.6  per  cent  of  54 
cases  of  paresis,  while  in  our  cases  the  proportion  is  38.18  per  cent. 

Unfortunately  we  have  not  yet  been  able  to  perform  the  Wassermann  reaction 
upon  a  sufficiently  large  number  of  children  of  our  patients  to  warrant  draw- 
ing conclusions  from  them.  It  may  suffice  to  say  that  Plant,  in  the  same  investi- 
gation referred  to,  found  26  among  100  children  in  these  same  families  to  show 
a  positive  Wassermann  reaction.  Forty-five  of  these  same  children  showed  some 
defect  in  their  physical  or  mental  makeup  although,  as  a  rule,  they  were  in- 
tellectually well  gifted. 

We  have  also  been  able  to  collect  86  cases  of  married  paretics  where  the 
anamnesis  concerning  matters  of  family  life  was  definitely  dependable  to  allow 
the  drawing  of  conclusions  concerning  the  matter  of  sterility,  abortions  and 
total  number  of  living  born  children.  The  situation,  is  set  forth  in  the  follow- 
ing table. 

CHILDREN  OF  MARRIAGES  OF  PARETICS. 


Total 
No. 

Sterile 
completely. 

Abortions 
only, 

Total 
number  of 
abortions. 

Living 

born 

children. 

Male  general  paretics 

76 
10 

22 
6 

10 

1 

41 
1 

110 

Female  general  paretics 

13 

Total 

86 

28 

11 

42 

123 

This  table  shows  that  of  86  marriages  39,  or  44.8  per  cent,  were  absolutely 
childless  at  the  time  one  of  the  two  mates  came  into  the  hospital  with  paresis. 
The  average  number  of  living  born  children  in  this  whole  group  is  1.4  children 
to  each  family.  If  we  subtract  from  both  totals  of  marriages  and  total  number 
of  children  two  cases  with  unusually  large  families  of  10  and  12  children  re- 
spectively, we  find  the  average  number  of  children  brought  down  to  1.2  per 
family.  If  we  consider  only  those  families  with  living  born  children  we  find  an 
average  of  2.24  children  per  family. 

But  study  of  these  histories  shows  that  at  the  time  the  paretic  parent  entered 
the  hospital  20  of  this  extremely  small  total  of  123  children  had  already  died. 
Usually  these  deaths  were  in  early  infancy,  as  in  the  following  illustrations: 
"One  immediately  and  one  at  the  end  of  the  first  day,"  "one  at  end  of  first 
week  and  the  other  of  hydrocephalus  at  five  months,"  "one  of  spasms  at  five 
weeks,"    "one    of   convulsions    in    early    infancy."      Subtracting   this    number    of 


34 

20  children  already  dead  and  omitting  the  two  distinctly  unusual  families  we 
find  at  the  time  the  patients  enter  the  hospital"  with  paresis  a  total  of  only 
81  living  children  among  84  families  or  less  than  one  living  child  per  family. 
These  observations,  showing  that  38.18  per  cent  of  the  mates  of  paretics  have 
syphilis;  that  the  children  to  a  large  number  show  either  evidences  of 
hereditary  lues  or  signs  of  congenital  weakness,  either  physical  or  mental; 
that  the  proportion  of  living  children  is  far  below  the  average  and  the  number 
of  childless  marriages  is  abnormally  high;  together  with  the  findings  of  Salmon, 
that  general  paralysis  in  New  York  State  stands  eighth  in  the  mortality  tables 
and  that  one  out  of  every  nine  male  deaths  between  40  and  60  is  from  general 
paralysis,  should  give  some  insight  into  the  magnitude  of  general  paralysis  as 
a   public  health  problem. 

Influence  of  Heredity. 

In  the  causation  of  insanity  two  factors  stand  out  above  all  others. 
One  of  these  is  the  quality  of  the  individual  and  the  other  is  the  influ- 
ences and  experiences  which  act  upon  him  from  his  surroundings.  The 
causes  acting  from  the  surroundings  are  illustrated  in  the  part  played  by 
alcohol  and  syphilis. 

The  quality  of  the  individual  is  determined  by  forces  which  exert  their 
influence  in  forming  the  material  which  goes  to  make  up  the  individual. 
These  forces  have  their  basis  in  the  strain  of  germ  plasm  which  is 
possessed  by  the  particular  family  line  from  w^hich  the  individual  comes. 
It  is  a  fact  that  some  individuals  may  be  unharmed  by  experiences  which 
produce  severe  mental  disorders  in  others.  This  must  have  its  explana- 
tion in  differences  in  their  mental  and  nervous  organization.  A  some- 
what larger  proportion  of  insane  individuals  show  abnormalities  of  mind 
or  nervous  system  among  ancestors  or  family  relations  than  do  the  sane. 

Among  4,917  individuals  admitted  to  the  Michigan  State  Hospitals  for 
the  Insane  during  the  years  1908  to  1914  and  regarding  whom  there  was 
satisfactory  information,  there  were  65.4  per  cent  who  had  among  their 
ancestors  or  family  such  hereditary  influences  as  insanity,  apoplexy  or 
paralysis,  psychopathic  abnormalities  or  alcoholism.  Diagram  XI,  Table 
17  of  the  Appendix. 

It  has  been  shown  by  experiment  and  abundantly  confirmed  by  obser- 
vation that  the  transmission  of  certain  qualities  follows  demonstrable 
laws  and  corresponds  to  the  Mendelian  Theory  that  each  individual  is  a 
sum  of  unit  qualities  which  may  be  transmitted  in  independent  form  to 
the  descendants.  These  qualities  have  a  tendency  to  assert  themselves  in 
succeeding  generations  or  may  remain  latent  and  reappear  again  under 
favorable  conditions  among  the  descendants  in  direct  or  related  lines. 

In  the  analysis  of  the  information  that  was  obtained  regarding  the 
distribution  of  hereditary  influences  among  the  families  of  the  insane, 
it  was  found  that  in  58.3  per  cent  of  instances  the  transmission  was 
direct  from  parent  to  child;  in  10.04  per  cent  the  abnormalities  were 
present  among  the  grand  parents ;  in  18.81  per  cent  they  were  among  the 
uncles,  aunts  or  cousins,  and  in  17.87  per  cent  they  were  among  the 
brothers  or  sisters  of  the  patient.  It  is  evident  that  abnormalities  of 
the  parents  are  of  far  greater  significance  for  the  health  of  descendants 
than  those  occurring  in  other  family  lines. 

Insanity  is  the  most  important  abnormality  which  is  transmitted  from 
the  ancestors  or  family  relations.  Among  the  admissions  who  had  any 
hereditary  influence  there  were  58.7  per  cent  who  had  an  ancestor  or  fam- 
ily relation  who  had  been  insane;  12.7  per  cent  had  apoplexy  or  paralysis 


35 


DIAGRAM  XI. 


HEREDITARY  FFICTORS 

or  ABI7  a=l5E5  fIDMITTED  TO 

MICHIGAN  STATE  HOSPITALS. 


a 


"^'y      APOPue^-i  ^ 


^S^CHOP/^THIC  CONO^T^^^  LjTl 


36 

as  an  inheritance ;  15.08  per  cent  had  relatives  who  showed  psychopathic 
abnormalities  and  13.4  per  cent  had  alcoholism  among  the  ancestors  or 
family. 

In  39.96  per  cent  of  those  patients  with  hereditary  abnormalities  one 
or  both  parents  had  been  insane.  In  many  instances  it  was  found  that 
several  members  of  a  family  were  insane  or  in  some  way  showed  nervous 
or  mental  abnormalties.  Among  237  families  in  which  there  was  more 
than  one  member  insane  or  abnormal  there  were  696  abnormal  individ- 
uals.   These  were  distributed  as  follows : 


In 

2 

families  there 

were  9  who 

were 

abnormal 

In 

2 

families  there 

were  8  who 

were 

abnormal 

In 

1 

family     there 

were  7  who 

were 

abnormal 

In 

8 

families  there 

were  6  who 

were 

abnormal 

In 

11 

families  there 

were  5  who 

were 

abnormal 

In 

31 

families  there 

were  4  who 

were 

abnormal 

In 

64 

families  there 

were  3  who 

were 

abnormal 

In  118 

families  there 

were  2  who 

were 

abnormal 

It  is  not  diflScult  to  find  among  the  families  of  the  insane  striking 
illustrations  of  the  transmission  of  insanity  through  different  genera- 
tions. The  accompanying  chart  of  the  family-  of  a  case  of  manic  depres- 
sive insanity  shows  the  occurrence  of  the  same  type  of  insanity  through 
four  generations. 


Generations. 


Psychopathic  STmn  Ho5Pn"Ai- 

Case     I05'7. 


D 


<D 


OyOung      d  ^oung. 


S 


S 


Q 


(^  (5 


(fW^ 


d  K  S.H. 


<b 


ID. 


(§  [3  (S  0 


JR 


ly. 


d.  yoong. 


CHART  Z8. 

This  chart  shows  the  occurrence  of  Insanity  in  four  generations  of  one  family.  The  pa- 
tient (IV,  6)  is  a  case  of  manic  depressive  Insanity,  as  was  her  mother  (III,  7).  Her  grand- 
mother (II,  4)  was  Insane  as  were  two  of  her  grandmother's  fraternity  (II,  5,  6)  one  of  whom 
died  at  the  Kalamazoo  State  Hospital.  The  patient's  great  grandmother  (I,  2)  also  was 
known  to  have  been  insane.  (For  explanation  of  the  symbols  used  in  the  above  chart  see 
first  chart  in  Appendix.) 


37 

The  conclusion  which  is  forced  upon  us  from  the  investigations  con- 
cerning the  influence  of  heredity  in  insanity  is  that  it  is  the  most  im- 
portant and  far-reaching  influence  in  the  production  of  insanity  that 
we  know  of,  not  only  in  determining  the  transmissibility  of  insanity 
itself  but  in  diminishing  the  resistance  of  the  individual  against  harm- 
ful external  influences  and  in  encouraging  the  perpetuation  of  abnormal- 
ities and  faniily  degeneracy. 

With  this  knowledge,  it  becomes  evident  that  no  person  who  has  been 
insane  should  have  children  and  it  would  be  best  for  them  not  to  marry. 
The  chance  of  safety,  for  their  own  happiness  or  health  of  their  de- 
scendants, is  too  slight. 

Summary. 

The  total  amount  of  insanity  under  treatment  in  the  State  Hospitals 
is  composed  of  a  considerable  number  of  different  forms  of  disease,  differ- 
ing in  their  causes,  the  symptoms  they  show,  the  mode  of  termination 
and  the  nature  of  the  pathological  process  in  the  brain.  To  intelligently 
understand  the  influences  which  are  concerned  in  the  production  of  in- 
sanity with  a  view  of  instituting  preventive  measures  it  is  essential  to 
consider  the  problem  in  its  relation  to  the  proportional  part  which  differ- 
ent clinical  types  contribute  to  the  total  amount  of  insanity.  One  may 
gain  an  idea  of  this  from  Diagram  XII  in  which  are  arranged  groups 
showing  the  proportional  occurrence  of  different  forms  of  insanity  among 
1,773  cases  of  insanity  admitted  to  the  Michigan  State  Hospitals  in  the 
year  1913-1914.  These  groups  have  been  more  or  less  arbitrarily  arrang: 
ed  with  the  purpose  of  directing  attention  to  common  features  in  the 
conditions  underlying  their  occurrence. 

In  the  group  of  insanity  due  to  syphilis,  alcohol  or  dinigs,  there  are 
included  23.06  per  cent  of  the  admissions  during  the  year.  In  this  type 
of  insanity  we  are  justified  in  stating  that  the  insanity  of  each  of  these 
individuals  resulted  from  a  cause  with  which  he  came  in  contact  through 
accident  or  his  own  choice. 

In  the  second  group  are  placed  forms  of  insanity  in  which  the  brain 
is  demonstrablv  diseased  in  its  structure.  It  embraces  senile  dementia, 
or  the  insanity  of  old  age,  which  in  this  tabulation  includes  disorders  of 
the  brain  due  to  diseased  blood  vessels.  Here  also  are  included  other 
forms  of  disease  of  the  substance  of  the  brain  and  those  instances  due 
to  changes  incident  to  various  physical  diseases.  The  entire  group  con- 
tributed 18.3  per  cent  of  all  admissions.  A  very  considerable 
proportion  of  this  group  must  be  regarded  as  preventable.  This  is  in 
large  part  true  where  diseases  of  the  blood  vessels  are  the  cause  of  the 
brain  disorder.  In  a  large  number  of  instances  these  result  from  such 
agencies  as  alcohol,  syphilis  or  preventable  physical  disorders.  In  the 
part  which  infectious  and  physical  diseases  contribute  to  this  group  it 
is  to  be  expected  that  as  improvements  occur  in  matters  of  public  hygiene 
these  diseases  will  lessen  in  frequency  and  their  relation  to  insanity 
diminish. 

A  third  group  includes  manic  depressive  insanity,  paranoid  delusional 
states  and  the  psychoneuroses,  and  constitutes  31.29  per  cent  of  the 
admissions.  Common  to  all  of  these  we  have  mental  abnormalities  which 
arise  out  of  peculiarities  of  personality  or  from  an  unstable  nervous 
organization  largely  dependent  upon  inherited  tendencies  toward  ab- 


38 


DIAGRAM  XH. 


COMPHRHTIVE  FREQUENCY  OF 
FORMS  OF  INSHN/TY  IN  /1DMJ55JONS 
TO  MICHIGAN  ST/^TE  HOSP/TRLS 
SEP  /.  1913  TO  RUG.  3L  I9I4-. 


j^\^ 


39 

normalities.  With  this  group  the  direction  of  efforts  at  prevention 
should  be  toward  restrictions  of  marriages  among  individuals  who  have 
mental  disorders. 

In  the  fourth  group  are  placed  several  fonns  of  insanity  which  have 
but  little  in  common,  and  regarding  whose  causes  we  know  little.  It 
includes  dementia  praecox,  epileptic  insanity  and  states  of  mental  de- 
fectiveness. Undoubtedly  in  a  considerable  number  of  the  instances  of 
mental  defectiveness  and  epilepsy  we  are  concerned  with  the  transmis- 
sion of  abnormalities  from  the  ancestors  and  any  efforts  at  preventing 
procreation  from  abnormal  individuals  will  materially  lessen  the  fre- 
quency of  these  disorders. 

Conclusions. 

The  conclusions  which  this  summary  justifies  are  that  there  are  cer- 
tain very  tangible  influences  continually  at  work  in  Michigan  in  the 
production  of  insanity  and  that  a  very  considerable  part  of  the  problem 
that  this  generation  is  forced  to  be  interested  in  is  the  result  of  the 
action  of  similar  forces  in  past  time. 

There  can  be  no  doubt  that  the  complexity  of  our  present  day 
civilization  carries  with  it  demands  which  make  it  less  easy  for  the 
individuals  who  are  less  resistant  in  their  nervous  organizations  to  pre- 
serve their  mental  health.  As  communities  become  more  highly  develop- 
ed it  becomes  less  possible  for  individuals  who  cannot  hold  their  thought 
and  conduct  within  conventional  lines  to  remain  outside  of  custoflial  care. 

There  seems  to  be  no  reason  to  doubt  that,  if  the  forces  which  are 
at  work  continue  without  abatement,  insanity  and  physical  and  nervous 
degeneracy  must  increase  with  even  greater  rapidity  than  in  the  past  and, 
apart  from  the  difficulties  and  expense  of  dealing  with  the  situation 
during  this  prsent  time,  which  we  have,  our  future  generations  must  have 
unreasonable  burdens. 

The  demands  put  upon  the  state  for  the  care  of  the  insane  are  extreme. 
From  1905  to  1914  the  state  has  paid  out  |12,327,259.83  for  the  main- 
tenance of  the  insane  and  for  special  purposes  connected  with  their  care. 
In  addition  to  this  it  must  be  remembered  that  during  the  first  year 
of  the  residence  of  an  insane  person  in  a  State  Hospital  the  expenses 
for  the  maintenance  are  borne  by  the  individual  counties. 

The  per  capita  distribution  of  the  cost  of  the  state  appropriations  for 
the  care  of  the  insane  has  increased  from  37.7  cents  in  1905  to  45.2  cents 
in  1914. 

The  peculiar  nature  of  insanity  and  the  special  demands  for  its  treat- 
ment make  it  necessary  that  the  insane  be  cared  for  in  public  institutions 
supported  by  the  state.  In  Michigan  the  State  Institutions  for  the  care  of 
the  insane  have  long  been  widely  known  for  their  excellency  of  organiza- 
tion and  economical  administration,  and  while  the  expense  for  their  ex- 
tension and  upkeep  is  large  the  necessities  of  the  situation  demand  that 
it  be  adequately  met. 

At  the  best  the  curative  treatment  of  insanity  has  marked  limita- 
tions and  in  spite  of  advances  within  recent  years  one  must  come  to 
the  conclusion  that  the  foremost  problem  is  that  of  prevention.  In  this 
lie  great  possibilities. 

Could  the  present  day  direct  influence  of  alcohol  and  syphilis  be 
abolished  the  state  would  be  relieved  of  the  care  of  nearly  a  fourth  of 


40 

the  cases  of  insanity  now  yearly  admitted  to  the  Michigan  State  Hos- 
jjitals.  The  beneficial  effects  which  would  result  in  other  directions 
from  the  removal  of  these  two  factors  alone  are  impossible  to  more 
than  surmise;  but  without  doubt  there  would  be  a  tremendous  lessen- 
ing in  future  generations  of  the  insanity  which  develops  on  the  foun- 
dation of  a  defective  nervous  and  mental  organization  such  as  manic 
depressive  insanity,  epilepsy  and  feeblemindedness. 

Another  very  tangible  source  of  the  perpetuation  and  continued  in- 
crease of  insanity  results  from  the  childbearing  of  those  who  are  feeble- 
minded or  insane.  In  its  relation  to  feeblemindedness  this  problem  has 
been  considered  elsewhere  in  this  report.  As  it  concerns  insanity  we 
have  shown  that  in  Michigan  58.7  per  cent  of  those  admitted  to  the 
State  Hospitals  had  some  ancestor  who  had  been  insane  and  in  23.4 
per  cent  of  instances  where  hereditarj'  abnormalities  were  present  one 
of  the  parents  had  been  insane. 

The  remedy  for  this  lies  in  making  it  impossible  for  those  who  have 
been  insane  to  marry.  It  seems  to  be  quite  evident  that,  in  spite  of 
the  provisions  of  the  laws  of  Michigan  which  prohibit  the  marriage  of 
those  who  are  insane,  such  marriages  continue. 

The  problem  of  the  prevention  of  insanity  is  largely  one  of  education 
of  the  citizens  of  the  state  to  an  under-standing  of  the  causes  of  insanity 
and  to  a  more  reasonable  regard  for  the  effects  of  their  own  acts  and 
influence  upon  their  descendents. 

General  Conclusions. 

In  Michigan  the  ratio  of  insane  in  institutional  care  is  27  per  10,000 
of  the  general  population.  This  ratio  is  about  the  same  as  that  of  states 
having  the  same  general  geographic  position  and  less  than  in  certain 
older  states  with  larger  facilities  for  the  care  of  the  insane. 

There  has  been  an  increase  of  145.2  per  cent  of  the  insane  in  institu- 
tional care  in  the  past  24  years.  In  large  part  this  increase  is  due  to 
an  increase  of  institutional  capacity. 

There  has  been  an  increase  of  43.7  per  cent  in  the  total  admissions  to 
the  Michigan  State  Hospitals  for  the  Insane  in  the  past  14  years. 

The  annual  admission  of  new  cases  of  insanity  has  increased  62.7  per 
cent  between  1901  and  1914. 

The  fact  that  the  ratio  of  admissions  estimated  to  10,000  of  the  popu- 
lation has  increased  from  4.5  in  1901  to  5.9  in  1910  indicates  that  the 
character  of  the  population  has  changed. 

Between  1901  and  1910  the  population  has  increased  16.1  per  cent 
and  the  annual  admission  of  new  patients  has  increased  51.3  per  cent. 

The  foreign  born  population  furnishes  a  much  larger  proportion  of  the 
annual  admissions  to  the  State  Hospitals  for  the  Insane  than  does  the 
native  bora.  The  ratio  for  10,000  of  foreign  born  being  8.9  and  for 
native  bora  5.4. 

Native  born  of  foreign  parents  have  a  rate  of  admission  166  per  cent 
greater  than  the  native  born  of  native  parents. 

Of  the  foreign  population  Russia  including  Poland,  Finland,  Scotland 
and  Ireland  have  a  higher  rate  in  relation  to  their  numbers  in  the  state 
than  other  foreign  nationalities. 

The  highest  rates  of  admission  are  in  districts  having  a  population  of 
2,000  to  5,000. 


41 

All  counties  having  large  State  Hospitals  for  the  Insane  have  the 
highest  ratio  of  admissions,  in  proportion  to  their  population.  It  is 
supposed  that  fewer  insane  individuals  in  these  counties  escape  com- 
mitment to  institutions  owing  to  their  proximity  and  greater  familiarity 
with  institutional  administration.  There  is  reason  to  believe  that  the 
rate  in  these  counties  approaches  the  truer  number  of  insane  needing 
commitment  than  in  counties  having  lower  rates. 

The  counties  of  the  upper  peninsula  have  relatively  higher  rates  in 
proportion  to  the  population  than  those  of  the  lower  peninsula. 

Insanity  is  most  liable  to  occur  between  the  ages  of  30  and  39.  The 
age  of  greatest  frequency  in  Michigan  has  changed  in  the  past  20  years 
from  the  ages  between  25  and  30  to  the  ages  between  35  and  40.  Within 
recent  years  there  has  been  a  great  increase  in  the  proportion  of  ad- 
missions of  individuals  above  the  age  of  50. 

In  general,  males  contribute  a  relatively  larger  proportion  of  insane 
individuals  than  do  females.  There  has  in  recent  jears  been  a  relatively 
larger  increase  in  the  proportion  of  male  admissions  than  females. 

Alcohol  is  the  direct  cause  of  insanity  in  8.4  per  cent  of  all  admis- 
sions to  Michigan  State  Hospitals  for  the  Insane.  Alcoholic  insanity 
is  6.5  per  cent  as  frequent  in  males  as  females.  This  form  of  insanity  is, 
however,  relatively  frequent  among  females,  this  sex  contributing  13.2 
per  cent  of  all  cases  of  this  disease.  Of  the  insane  31.2  per  cent  are 
more  than  moderate  in  their  use  of  alcoholic  drinks. 

Drug  habits  are  productive  of  only  a  small  proportion  of  the  cases  of 
insanity  admitted  to  the  State  Hospitals. 

Syphilis  is  the  cause  of  12.9  per  cent  of  the  cases  of  insanity  annually 
admitted  to  the  Michigan  State  Hospitals.  It  was  the  direct  cause  of 
insanity  in  17.5  per  cent  of  all  males  and  6.65  per  cent  of  all  females 
admitted.  As  shown  by  the  Wasserman  test  21.6  per  cent  of  all  in- 
sane have  syphilis. 

The  conjugal  mates  of  38.18  per  cent  of  all  individuals  having  paresis 
have  syphilis. 

In  44.8  per  cent  the  marriages  of  paretics  are  childless  and  their  num- 
ber of  living  children  is  abnormally  low. 

Heredity  is  the  most  important  and  far-reaching  influence  in  the  pro- 
duction of  insanity. 

Of  the  insane  05.4  per  cent  have  insanity  or  nervous  abnormalities  pres- 
ent in  their  ancestors  or  families.  In  58.3  per  cent  the  transmission  was 
from  parent  to  child.  The  most  frequent  hereditary  influence  is  insanity, 
this  being  present  in  58.7  per  cent  of  those  who  had  any  hereditary  in- 
fluence. 

The  total  number  of  abnormal  individuals  is  strikingly  high  in  families 
of  the  insane. 


42 


CHAPTER  IT.— FEEBLEMINDEDNESS  AND  EPILEPSY.* 

Introduction. 

For  a  period  of  some  ten  or  fifteen  years,  there  has  been  an  ever  in- 
creasing interest  in  the  problems  presented  by  the  feebleminded  class. 
There  has  been  a  growing  appreciation  of  the  fact  that  feebleminded- 
ness entered  in  and  complicated  a  great  many  problems,  especially  those 
connected  with  dependency,  crime  and  sexual  immorality.  In  order  to 
ascertain  the  extent  and  the  nature  of  the  relationship  of  feebleminded- 
ness to  juvenile  delinquency  and  dependency  in  the  State  of  Michigan, 
this  Commission  undertook  a  study  of  the  inmates  of  the  Lansing  In- 
dustrial School  for  Boys  and  the  Adrian  Industrial  Home  for  Girls, 
and  of  all  the  inmates  of  the  County  Infirmaries  in  the  state.  Before 
turning  to  the  discussion  of  these  investigations,  which  are  found  in 
other  sections  of  this  chapter,  it  is  necessary  to  first  discuss  the  gen- 
eral nature  of  feeblemindedness,  and  the  problem  which  it  presents. 

Feeblemindedness  is  defined  by  Tredgold  as  ''a  state  of  mental  defect 
from  birth,  or  from  an  early  age,  due  to  incomplete  cerebral  develop- 
ment, in  consequence  of  which  the  person  affected  is  unable  to  perform 
his  duties  as  a  member  of  society  in  the  position  of  life  to  which  he  is 
born."  This  definition  is  a  general  one,  embracing  all  degrees  of  feeble- 
mindedness. There  are  in  common  acceptation  in  this  country,  three 
terms  used  to  express  differing  degrees  of  feeblemindedness:  idiocy,  im- 
becility, and  the  moron  group. 

A  clear  idea  of  the  extent  of  the  defectiveness  of  individuals  in  these 
different  groups  may  be  obtained  by  comparing  their  mental  develop- 
ment with  that  of  normal  children  of  different  ages.  The  idiot  is  a 
feebleminded  individual  whose  mental  development  has  never  progressed 
beyond  the  point  attained  by  the  normal  child  at  the  end  of  its  second 
year.  The  mental  development  of  those  classed  as  imbeciles  corresponds 
to  that  of  children  from  three  to  seven  years  of  age.  The  moron  group 
represents  all  the  feebleminded  whose  mental  development  is  greater 
than  that  of  a  child  of  seven.  The  morons  are  ^'persons  who  may  be 
capable  of  eaniing  a  living  under  favorable  circumstances,  but  are  in- 
capable from  mental  defect  existing  from  birth  or  from  an  early  age  of 
competing  with  their  normal  fellows,  or  of  managing  themselves  and  their 
affairs  with  ordinary  prudence."** 

It  will  be  seen  from  these  facts  that  while  the  idiots  and  the  lower 
grades  of  imbeciles  are  so  defective  that  their  permanent  care  is  neces- 
sary, yet  they  are  not  a  class  which  will  tend  to  propagate.  It  is  the 
high  grade  imbeciles  and  the  morons  who,  though  capable  of  contributing 
either  partly,  or  in  whole  to  their  own  support,  yet  are  the  types  which 
menace  society  with  the  increase  of  their  kind.  . 

Environmental  conditions  existing  during  the  embryonic  period  or  the 
early  years  of  an  individual's  life,  or  accidents  happening  during  this 

•  By  Harry  W.  Crane,  Ph.  D.,  in  collaboration  with  Miss  Adele  E.  McKinnie  and  also, 
for  the  section  on  Feeblemindedness  in  Relation  to  Juvenile  Delinquency,  with  Miss  Sarah 
D.  Mackay  and  Mr.  Charles  Webber. 

♦•Definition  suggested  by  the  Royal  College  of  Physicians  of  London  and  adopted  by  the 
British  Royal  Commission  on  the  Care  and  Control  of  the  Feebleminded,  to  describe  the 
highest  grade  of  feeblemindedness. 


43 

same  period  may  result  in  the  feeblemindedness  of  that  individual.  Yet 
all  the  authorities  on  the  subject  agree  that  feeblemindedness  more  often 
is  the  result  of  a  morbid  heredity  than  of  environmental  causes.  The  de- 
gree to  which  inheritance  dominates  environmental  influences  as  a  cause 
of  feeblemindedness  is  variously  stated.  Hovt^ever,  Goddard,  Davenport, 
and  Tredgold  agree  that  in  at  least  80  per  cent  of  the  cases  of  feeble- 
mindedness heredity  is  the  dominant  cause.  Dr.  Goddard  has  found  that 
of  the  cases  cared  for  in  his  institution,  65  per  cent  were  from  parents, 
either  one  or  both  of  whom  were  feebleminded. 

The  consensus  of  opinion  is  that  the  Mendelian  law  is  in  the  main 
applicable  to  the  inheritance  of  feeblemindedness.  The  most  definite 
portion  of  the  law  which  applies  to  the  inheritance  of  feeblemindedness 
is  that  which  refers  to  the  mating  of  two  feebleminded  individuals.  The 
probable  result  of  such  an  union  would  be  offspring  all  of  whom  were 
feebleminded.  Since  feeblemindedness  is  so  largely  the  result  of  heredi- 
tary factors,  procreation  by  feebleminded  individuals  should  be  pre- 
vented. 

But  what  is  the  problem  of  feeblemindedness  in  Michigan?  It  is 
desirable  to  know  the  extent  of  feeblemindedness  in  the  state,  the 
means  being  used  for  its  control,  and  the  adequacy  of  such  means. 

It  is  known  that  on  the  30th  of  June,  1914,  there  were  in  the  Michigan 
Home  and  Training  School,  1,141  individuals  of  defective  mentality.  Of 
this  number  .'i24  were  also  epileptic.  On  this  same  date,  there  were  on 
the  waiting  list  of  this  institution  165  individuals  who  were  in  no  other 
public  institution.  Of  this  number,  34  were  epileptic.  There  were  at  the 
Michigan  Farm  Colony  for  Epileptics  24  individuals.  Of  the  patients 
who  were  in  the  State  Hospitals  for  the  Insane  (including  the  Wayne 
County  Asylum),  196  of  the  males  and  157  of  the  females  were  feeble- 
minded, while  260  more  of  the  males  and  148  more  of  the  females  were 
epileptic.  Moreover,  during  the  year  ending  September  1,  1914,  there  were 
admitted  to  the  Michigan  State  Hospitals  for  the  Insane  77  defectives 
and  99  epileptics.  There  were  also  at  St.  Joseph's  Retreat  eight  male  and 
14  female  epileptics  as  well  as  seven  males  and  20  females  who  were  feeble- 
minded. At  St.  Anthony's  Home  there  were  eight  males  and  16  females 
who  were  feebleminded.  The  investigations  of  this  Commission  have 
shown  that  of  3,334  County  Infimary  inmates  710  were  feebleminded  and 
114  more  were  epileptic.  Also  that  of  the  386  girls  at  the  Adrian  In- 
dustrial Home  at  least  131  were  feebleminded,  while  of  the  809  boys  at 
the  Lansing  Industrial  School,  there  were  at  least  171  who  were  feeble- 
minded. The  extent  of  feeblemindedness  in  the  community  at  large  was 
indeterminable  by  the  Commission  because  of  the  limited  time  at  its 
disposal.* 

♦The  supervisors  of  each  township  and  ward  in  the  state  are  required  by  law  (section  4637 
C.  L.  1897)  to  make  a  report  to  the  Secretary  of  State  of  "the  names  of  all  insane,  deaf  and 
dumb,  dumb,  blind,  epileptic  and  idiotic  persons  in  his  township  or  ward."  These  reports  for 
the  year  1914  show  that  besides  the  number  we  have  found  in  the  County  Infirmaries  of  the 
state  there  were  at  least  278  feebleminded  males  and  17  probably  feebleminded  males  ;  165 
feebleminded  females  and  21  probably  feebleminded  females  of  whom  127  were  child-bearing 
age ;  141  epileptic  males  and  71  epileptic  females  of  whom  52  were  of  child-bearing  age,  who 
were  living  out  of  institutions. 

In  considering  these  figures  several  things  must  be  borne  in  mind.  Some  of  the  names 
given  in  these  reports  were  probably  also  included  in  the  number  given  on  the  waiting  list 
of  the  Lapeer  Home  and  Training  School.  These  lists  of  names  are  incomplete,  as  in  many 
instances  only  the  more  marked  cases  of  feeblemindedness  are  reported.  These  lists  are  also 
inaccurate.  Oftentimes  the  individuals  making  the  report  are  unable  to  distinguish  between 
ca.ses  of  insanity  and  feeblemindedness.  In  many  other  cases  deaf  and  dumb  individuals 
who  were  clearly  feebleminded  have  been  reported  as  "intelligent."  However,  despite  in- 
adequacies and  inaccuracies  these  figures  do  indicate  that  there  are  a  considerable  number  of 
feebleminded  and  epileptic  individuals  who  are  at  large  in  the  community. 


44 

Michigan  has  realized  the  fact  that  feeblemindedness  is  transmissible 
from  generation  to  generation  and  consequently  has  adopted  measures 
to  prevent  procreation.  It  has  laws  prohibiting  the  marriage  of  a  feeble- 
minded or  an  epileptic  individual  and  inflicting  heavy  penalties  upon  any 
one  a  party  to,  or  aiding  such  a  marriage.  However,  such  laws  are  not 
enforced,  nor  is  there  a  suflScient  public  sentiment  to  demand  their  en- 
forcement. Even  at  the  present  day,  we  find  public  oflScials  instrumental 
in  effecting  such  marriages. 

However,  even  were  there  the  strictest  enforcement  of  these  laws,  yet 
the  illicit  propagation  of  the  feebleminded  would  not  be  prevented.  Under 
our  present  system,  which  makes  the  marriage  of  defectives  an  easy 
matter,  there  are  numbers  of  unmarried  feebleminded  women  bearing 
children.  Thirty  per  cent  of  the  unmarried  feebleminded  women  in  the 
County  Infirmaries  had  had  children.  If  restrictions  against  marriage 
were  enforced,  it  would  merely  mean  that  these  illegal  unions  would 
be  increased. 

Michigan  also  recently  enacted  a  law  authorizing  the  sterilization  of 
its  insane  and  mentally  defective.  This  law,  however,  is  inadequate 
from  two  standpoints.  It  limits  the  application  of  this  means  of  pre- 
venting the  propagation  of  the  feebleminded  class  to  those  who  are  in 
institutions   and   therefore  least   likely  to   reproduce.     Moreover,  -very 


COUNTV    2Z. 
Case   I. 


I.         ll/i4Ai 

5^^  sterilized  -committed loLopeer.  H.*T.&. 

"F# ^ 


Co.  I 

5.RS 


I 

6 


CHART  6. 


This  woman  (1)  was  sterilized  under  the  new  Michigan  State  Law,  11/24/13.  She  is  the 
typical  moron,  a  big,  strong,  healthy  girl,  except  for  venereal  infection.  She  had  one  child 
by  her  feebleminded  husband,  which  was  taken  from  the  County  Infirmary  to  the  State 
Public  School.  Her  other  three  children  were  illegitimate,  two  of  them  born  at  the  County 
Infirmary  and  taken  to  Coldwater.  She  is  now  beyond  all  possibility  of  doing  harm  to  so- 
ciety by  the  propagation  of  her  kind.  (For  explanation  of  the  symbols  used  in  the  above 
chart  see  first  chart  in  Appendix.) 


45 

little  advantage  has  been  taken  of  the  right  given  by  this  act  to  pre- 
vent procreation. 

In  only  two  of  the  instances  of  feeblemindedness  encountered  in  the 
County  Infirmaries  had  sterilization  under  the  terms  of  this  act  taken 
place.  That  there  was  indeed  need  to  prevent  procreation  in  each  of 
these  cases  is  clearly  shown  in  charts  6  and  27.    However,  there  are  a 


COUNXV    T8. 
Case  504-. 


d.  Toledo 
Co.  I. 


^ 


<D 


D-. 


Il/i5/i3 

sterilized 


Q 


~    VpJC0<n">'»«3  will 


F? 


6  6 


b.Tbleelo 
Col. 


bToledo 
Col. 


CHART  2.1. 

This  woman  of  24  years  who  has  the  mentality  of  a  girl  of  7  is  a  typical  case  of  the 
feebleminded  woman  who  is  irresponsible  sexually  and  no  doubt  exploited  at  every  turn. 
She  has  had  four  illegitimate  children,  two  born  at  the  Toledo  County  Infirmary  and  her 
last  one  born  at  the  County  Infirmary  whore  she  is  now  resident.  She  was  sterilized  11/15/13 
and  is  awaiting  her  admission  to  the  Lapeer  Home  and  Training  School.  (For  explanation  of 
the  symbols  used  in  the  above  chart  see  first  chart  in  Appendix.) 

great  many  women,  as  some  of  the  charts  presented  later  clearly  show, 
whose  fertility  was  an  equal  menace  to  society.  There  are  several  rea- 
sons for  the  limited  extent  to  Avhich  the  remedy  of  sterilization  has  been 
used  in  Michigan.  Shortly  after  the  passage  of  the  state  law  authoriz- 
ing this  operation,  a  decision  of  the  Supreme  Court  of  New  Jersey  de- 
clared a  very  similar  law  unconstitutional.  As  a  result,  this  decision 
and  a  consequent  temerity  of  the  medical  profession  of  this  state,  has 
rendered  the  Michigan  physicians  loath  to  perform  the  operation.  There 
are  also  a  considerable  number  of  people  who  feel  that  the  act  of  sterili- 
zation, while  preventing  procreation,  is  a  menace  to  society  in  that,  by 
removing  the  restriction  of  sexual  intercourse  caused  by  fear  of  the 
possibility  of  consequent  offspring  it  would  tend  to  increase  promiscuity 
and  spread  disease.  Whether  or  not  this  argument  is  valid  cannot  be 
proved  by  any  evidence  at  hand.  The  opposition  of  still  another  group 
of  individuals  is  motivated  by  the  sentimental  feeling  that  we  have  no 
right   to   remove   a   God-given   right.     Fortunately,   this   feeling  which 


46 

places  the  individual's  gratification  above  the  social  welfare,  is  grow- 
ing weaker  and  weaker.  However,  due  to  a  doubt  as  to  the  legality  of 
sterilization  and  to  a  public  opinion  that  does  not  yet  seem  inclined 
to  accept  this  preventive  measure,  the  law  authorizing  the  operation  in 
this  state  is  practically  a  dead  letter. 

Michigan  also  has  attempted  to  segregate  the  feebleminded  members 
of  the  state.  At  the  present  time,  however,  its  institution  for  the  spe- 
cial care  of  this  class  is  crowded  to  the  limit  and  has  a  large  waiting 
list.  There  are  about  a  fourth  of  the  boys  and  about  a,  third  of  the 
girls  in  the  juvenile  reformatories  who  are  feebleminded  and  in  a  very 
few  years  will  be  turned  out  into  the  community  at  large.  There  are 
about  one  fourth  of  the  inmates  of  the  County  Infirmaries  of  the  state 
who  are  either  feebleminded  or  epileptic  and  who  are  neither  adequately 
nor  permanently  segregated. 

Since  our  marriage  laws  are  not  enforced,  and  since,  if  they  were  en- 
forced, the  propagation  of  the  unfit  would  not  be  prevented,  and  since 
prevention  by  the  means  of  sterilization  has  not  been  and  probably  will 
not  be  taken  advantage  of,  the  one  method  that  stands  out  clearly  as 
the  most  effective  means  of  preventing  the  increase  of  .our  feebleminded 
class  is  increasing  the  extent  of  the  segregation  of  its  members.  In  the 
following  sections  on  feeblemindedness  in  relation  to  delinquency  and 
dependency  are  given  facts  indicating  that  an  especial  effort  should 
be  made  to  permanently  segregate  the  feebleminded  women  of  child- 
bearing  age. 


FEEBLEMINDEDNESS  IN  RELATION  TO  JUVENILE 

DELINQUENCY. 

Introduction. 

The  task  which  the  Commission  assumed  in  regard  to  the  Lansing 
Industrial  School  for  Boys  and  the  Adrian  Industrial  Home  for  Girls 
was  primarily  that  of  determining  the  number  of  feebleminded  children 
in  these  two  institutions.  Yet  in  conjunction  with  this  work,  it  at- 
tempted to  gain  other  information  which  might  have  a  bearing  either 
upon  the  mental  condition  of  the  children  or  upon  their  delinquency. 
Information  was  sought  concerning  the  school  history,  the  physical  con- 
dition, the  employment  record  and  the  delinquent  record  of  the  inmates 
themselves.  An  attempt  was  also  made  to  ascertain  the  delinquent  and 
dependent  record,  the  alcoholic  and  sex  habits,  the  physical  condition 
and  marital  condition  of  the  parents.  It  was  felt  that  facts  of  this 
nature,  as  well  as  any  similar  facts,  which  could  be  obtained  concern- 
ing the  other  relatives,  might  have  had  either  an  environmental  or  heredi- 
tary- influence,  or  both,  upon  the  children. 

Mental  Status. 

Turning  first  to  the  mental  classification  of  the  inmates  of  the  schools: 
Each  inmate  was  tested  by  the  Binet  method.  Briefly  giving  the  facts — 
as  based  upon  the  tests — it  can  be  conservatively  stated  that  of  the  809 


47 

cases  at  the  Lansing  Industrial  School,  171  or  21.34  per  cent  fell  defi- 
nitely and  clearly  in  the  feebleminded  group.  The  same  series  of  tests 
conducted  at  the  Adrian  Industrial  Home  showed  that  34  per  cent  of 
the  inmates  were  plainly  feebleminded.  The  detailed  figures  from  which 
these  percentages  ^re  obtained  are  given  in  Tables  19  and  20  on  Page  — . 
of  the  Appendix.  It  must,  however,  be  emphasized  that  these  figures  are 
obtained  from  a  somewhat  arbitrary  application  of  a  fixed  test.  As  a  re- 
sult of  this  method,  and  the  inadequacy  of  the  test  as  a  means  of  de- 
termining the  mental  status  of  the  higher  grade  defectives,  the  figures 
above  given  are,  undoubtedly,  much  lower  than  they  should  be. 

For  this  reason,  another  grouping  of  all  the  inmates  of  each  school 
was  determined  upon.  It  was  decided  that  each  investigator  should, 
in  addition  to  the  information  given  by  the  Binet  Test,  use  such  per- 
sonal impression  as  he  could  gain  from  his  contact  with,  and  study  of, 
each  individual  whom  he  tested  as  an  aid  in  determining  whether  or 
not  this  individual  belonged  to  the  Normal  or  Feebleminded  Group.  As 
might  be  expected,  proceeding  in  this  way,  the  investigators  found  many 
cases  which  they  were  unwilling  to  place  in  either  the  Normal  or  the 
Feebleminded  Group.  There  were  a  number  of  individuals  who  tested 
too  low  to  be  classed  as  normal,  yet  whose  reaction  to  the  test  ques- 
tions and  to  the  investigators,  when  taken  into  consideration  with  such 
facts  as  excessively  bad  environmental  conditions,  recent  immigration 
to  this  country  from  non-English  speaking  countries,  etcetera,  made  it 
seem  impossible  to  class  as  feebleminded.  There  were  other  cases  who 
tested  just  too  high,  according  to  the  arbitrary  Binet  standard  to  be 
classed  as  feebleminded,  yet  whose  reactions  were  indicative  of  inherent 
mental  defectiveness.  Clearly  such  cases  ought  not  to  be  classed  as 
normal. 

As  a  result  of  these  considerations,  the  following  five  groups  were  final- 
ly decided  upon: 

Normal,  Near  Normal,  Backward,  Feebleminded  and  Subnormal.* 

On  this  basis  of  division,  we  find  the  following  distribution  of  the 
inmates : 

LANSING. 

Group  Number  Per  cent 

Normal    100  12.38 

Near  Normal    163  20.15 

Backward    233  28.80 

Feebleminded    214  26.45** 

Subnormal    99  12.24 

•In  this  connection,  It  is  interesting  to  note  the  classification  adopted  by  the  Psychological 
investigators  of  the  New  Jersey  State  Home  for  Girls,  Trenton,  N.  J.  Previous  to  their  work 
for  1913  and  1914  they  had  used  a  three-fold  classification.  I-Normal.  II-Borderline,  Ill- 
Defective.  In  their  annual  report  for  the  period  ending  October  31,  1914,  they,  however, 
enlarge  this  classification  by  subdividing  their  borderline  cases  into  Backward  "those  Just 
above  the  line,  practicallv  Normal"  and   Subnormal  "those  just  below  the  line." 

♦♦The  number  of  feebleminded  here  tabulated  Includes  not  only  the  21.3  per  cent  of  the  boys 
at  Lansing  and  34  per  cent  of  the  girls  at  Adrian  whom  the  Binet  method  alone  showed 
to  be  feebleminded,  but  also  an  additional  5.1  per  cent  of  the  boys  at  Lansing  and  16.7 
per  cent  of  the  girls  at  Adrian  who  were,  according  to  the  investigator's  opinion,  definitely 
feebleminded. 


48 

ADRIAN. 

Normal    31                      8.03 

Near  Normal   31                     8.03 

Backward    46  11.91 

Feebleminded ]1)5  50.52* 

Siibnoraial 83  21.50 

In  the  following  discussions  and  in  the  tabulation  of  all  figures  in  the 
statistical  Appendix,  unless  specifically  stated,  when  the  Normal  Group 
is  mentioned,  reference  is  made  to  all  the  individuals  in  the  Normal,  Near 
Normal  and  Backward  classes;  when  the  Feebleminded  Group  is  spoken 
of,  reference  is  made  to  all  individuals  in  the  Feebleminded  and  Sub- 
normal classes. 

At  Lansing  there  were  496  or  61  per  cent  of  the  inmates  in  the  Nor- 
mal Group  while  there  were  313  or  39  per  cent  in  the  Feebleminded 
Group. 

In  the  Normal  Group  at  Adrian  there  were  108  or  27.98  per  cent  of 
the  inmates  and  in  the  Feebleminded  Group  278  or  72.02  per  cent. 

Grade  and  Age  of  Leaving  School. 

As  bearing  upon  our  grouping  of  individuals  into  the  two  large  classes 
of  Normal  and  Feebleminded,  there  are  two  related  groups  of  facts 
which  are  of  interest.  These  facts  are  the  age  at  which  the  inmates  of 
the  two  industrial  schools  left  the  public  schools  and  the  school  grade 
to  which  they  had  attained  at  that  time. 

While  the  average  age  at  which  the  I.»ansing  Industrial  School  boys 
in  the  Normal  Group  left  school  was  12.44  years  and  that  of  the  Feeble- 
minded boys  12.97  years — the  average  grade  reached  by  the  former  was 
the  fifth  (5.01)  while  that  reached  by  the  latter  was  not  quite  the  fourth 
(3.73).  Thus  while  the  bojs  in  the  Normal  Group  averaged  one-half 
year  younger  when  they  left  school  than  did  those  in  the  Feebleminded 
Group,  they  were  at  that  time  over  a  grade — that  is,  over  one  year's 
work — in  advance  of  the  boys  in  the  Feebleminded  Group.  (See  Table  21.) 

Practically  the  same  relation  of  age  of  leaving  school  and  of  grade 
attained  is  shown  by  the  figures,  obtained  from  the  two  groups  of  girls 
at  Adrian.  The  girls  of  the  Normal  Group  left  school  at  an  average 
age  of  13.55,  a  slightly  higher  age  than  did  the  girls  of  the  Feebleminded 
Group,  who  left  at  an  average  age  of  13.39.  Yet  the  former  had  attained 
a  much  higher  school  grade  (6.71)  than  had  the  latter  (5.14).  The 
girls  of  the  Normal  Group,  with  the  advantage  of  being  only  one-fifth 
of  a  year  older  when  they  left  school  than  were  the  girls  of  the  Feeble- 
minded Group,  had  advanced  one  and  one-half  years  farther  in  their 
school  work. 

It  is  to  be  regretted  that  facts  could  not  be  obtained  regarding  the  age 
at  which  the  children  started  their  school  work,  thus  making  it  possible 
to  ascertain  the  number  of  years  each  group  has  been  in  school  attend- 
ance. There  are,  however,  two  considerations  that  would  lead  one  to 
suppose  that  in  all  probability,  both  the  children  in  the  Normal  and  in 
the  Feebleminded  Group  were  in  school  attendance  approximately  the 
same  number  of  years.  We  have  the  fact  that  the  difference  in  the 
mentality  of  the  members  of  the  two  groups  had  no  appreciable  influence 

•See  foot     note  on   pi-ocoding  page. 


49 

upon  the  age  at  which  they  left  school.  Then,  there  is  also  the  fact 
that  there  are  practically  no  low  grade  cases  in  the  Feebleminded  Group 
which  we  are  considering.  It  is  probable  that  it  is  only  the  low  grade 
cases  of  feeblemindedness,  the  very  defective,  that  would  in  their  early 
years  be  so  retarded  in  development  as  to  be  kept  from  starting  school 
at  the  usual  age. 

Briefly  summarized  then,  the  facts  for  Lansing  and  Adrian  agree  in 
showing  that  the  members  placed  in  our  so-called  Normal  Group  and 
those  in  our  so-called  Feebleminded  Group  left  school  at  practically  the 
same  age  and  yet  the  former  were  over  a  year  further  advanced  in  their 
school  work  than  were  the  latter.  This  relation  of  facts  would  seem  to 
corroborate  the  groupings  of  individuals  as  made  by  the  investigators. 

There  is  one  group  of  facts  that  might  at  first  glance  seem  to  vitiate 
the  above  conclusion.  It  was  found  that  the  school  attendance  of  the 
individuals  in  the  Normal  Group  was  more  regular  than  was  that  of 
the  individuals  in  the  Feebleminded  Group.  At  Lansing  20  per  cent  of 
the  Normal  Group  attended  school  regularly,  26  per  cent  with  slight 
irregularity,  and  51  per  cent  very  irregularly.  In  the  case  of  the  Feeble- 
minded Group  only  8  per  cent  attended  regularly  and  16.29  per  cent  with 
slight  irregularity,  while  68.35  per  cent  attended  very  irregularly.  Prac- 
tically the  same  difference  existed  between  the  attendance  of  the  two 
groups  at  Adrian.  Of  the  Normal  Group  47  per  cent  were  regular  in  at- 
tendance, 35  per  cent  slightly  irregular  and  18  per  cent  were  very  irregu- 
lar while  of  the  Feebleminded  Group,  32  per  cent  were  regular  in  attend- 
ance, 31  per  cent  slightlv  irregular  and  37  per  cent  very  irregular.  (See 
Table  21.) 

While  it  might  be  thought  at  first  that  these  figures,  showing  greater 
irregularity  of  attendance  on  the  part  of  the  individual  in  the  Feeble- 
minded Group,  would  invalidate  our  previous  conclusions  by  offering  the 
true  explanation  of  their  poor  showing  in  school  advancement,  yet  be- 
fore accepting  this  conclusion,  there  is  another  aspect  of  the  situation 
to  be  considered.  It  must  be  remembered  that  the  public  schools,  con- 
ducted as  they  are  for  normal  children,  fail  to  enlist  the  interest  of  the 
child  whose  mentality  is  below  that  of  his  fellows  and  that  this  makes 
toward  irregularity  in  attendance.  In  fact,  we  are  of  the  opinion  that 
the  very  irregularity  of  the  attendance  of  the  members  placed  in  our 
Feebleminded  Group  is  further  evidence  of  their  defectiveness. 

In  considering  the  various  facts  that  are  related  to  either  the  de- 
linquencies, or  the  mentality  of  the  two  groups,  we  feel  that  attention 
should  be  called  to  the  method  in  which  these  facts  were  obtained.  The 
investigator  interviewed  each  individual,  studied  the  commitment  papers, 
the  institutional  records,  and  gained  all  possible  information  from  the 
teachers  of  the  institution.  The  facts  which  we  are  about  to  quote  are 
based  upon  this  infonnation.  It  is  to  be  regretted  that  field  work, 
including  visits  to  the  neighborhood  and  home  of  each  individual  could 
not  have  been  made.  This  would  have  given  an  additional  and  more  con- 
cise picture  of  the  exact  environmental  soil  from  which  our  delinquents 
sprang.  In  many  cases  it  undoubtedly  would  have  clearly  depicted  the 
close  inter-relation  existing  between  environmental  factors  and  a  defi- 
cient hereditary  mental  endowment  as  causes  of  delinquencies.  However, 
the  limitations  of  time  made  such  an  intensive  study  impossible.  But 
even  without  this  field  work,  we  feel  that  our  results  are  sufficiently 
7 


50 

exact  and  suflSciently  large  to  indicate  relations  that  are  of  enough  im- 
portance to  deserve  consideration  by  those  interested  in  the  problem  of 
feeblemindedness  and  especially  this  problem  in  relation  to  juvenile  de- 
linquency. 

Physical  Factors. 

Among  other  factors  which  are  of  prime  importance  in  any  study  of 
either  the  delinquent  or  the  defective  class  is  the  physical  condition  of 
its  members.  Certain  physical  defects,  such  as  poor  teeth,  poorly  placed 
teeth,  anomalies  of  the  dental  arch,  enlarged  tonsils  and  adenoids,  under- 
nourished bodies,  defective  vision  or  hearing  are  often,  in  the  growing 
child,  influential  factors  in  causing  even  extreme  backwardness  in  men- 
tal development  as  well  as  by  the  very  fact  of  lessening  physical  and 
nervous  resistance,  making  the  child  more  susceptible  to  bad  environ- 
mental influences.  These  very  conditions  again  make  it  impossible 
for  the  individual  to  keep  up  with  the  school  work.  Consequently,  he 
becomes  discouraged,  plays  truant,  gets  into  bad  gangs  and  forms  bad 
habits.  The  whole  is  a  vicious  chain,  never  ending,  but  each  link  re- 
enforcing  each  other  link. 

Other  physical  anomalies  and  even  some  of  those  defects  we  have  al- 
ready mentioned,  are  often  the  physical  concommitants  of  congenital 
mental  defectiveness.  At  each  of  the  schools  there  was  a  considerable 
proportion  of  physical  defects.     (See  Table  22.) 

Of  the  total  809  boys  examined  10  per  cent  (78)  had  irregular  teeth; 
four  per  cent  (34)  widely  spaced  teeth;  three  per  cent  (22)  first  teeth 
(indicating  retarded  physical  development)  ;  and  eight  per  cent  (62) 
poor  teeth.  Of  the  total  number  there  were  seven  per  cent  (59)  whose 
teeth  were  in  really  good  condition. 

Tonsils  and  adenoids  were  or  had  been  present  in  a  large  per  cent  of 
the  cases.  There  were  five  per  cent  (38)  of  the  individuals  who  had  had 
either  adenoids  or  tonsils  removed  while,  as  accurately  as  could  be 
'observed  by  one  without  special  medical  training,  35  per  cent  (286) 
had  at  that  time  either  adenoids  or  enlarged  tonsils.  There  was  also 
an  additional  five  per  cent  (39)  of  the  cases  in  which  the  presence  of 
adenoids  was  suspected.  Of  all  the  cases  examined  10.5  per  cent  were 
mouth  breathers.  Defective  palatal  arches  were  noted  in  five  per  cent 
of  the  cases. 

While  the  number  of  individuals  having  markedly  defective  hearing  or 
vision  was  not  excessive,  it  is  large  enough  to  be  significant.  There 
were  37  or  five  per  cent  of  the  cases  whose  hearing  was  defective  and  108 
or  13  per  cent  with  defects  of  the  eyes.  Of  the  809  cases,  10  per  cent 
(79)  had  defects  of  vision;  two  per  cent  (14)  wore  glasses;  two  per  cent 
(15)   showed  strabismus. 

General  conditions  of  physical  underdevelopment  of  various  grades, 
were  also  noted  in  a  considerable  per  cent  of  the  cases.  Fifteen  per  cent 
(118)  were  slightly  undersized;  16  per  cent  (128)  were  decidedly  under- 
sized; while  11  per  cent  (91)  more  were  weak  and  anemic.  Of  equal 
interest  is  the  fact  that  of  the  total  809  only  13  per  cent  (104)  were 
notably  well  formed  and  proportioned. 

There  were  a  few  cases  of  each  of  several  definite  physical  defects  and 
diseases.     The  most  Avorthy  of  note  are  the  eight  cases  of  venereal  dis- 


51 

ease,  15  of  thyroid  enlargement,  four  hernia,  seven  probable  tuberculosis, 
one  hemiplegia,  15  cripples. 

There  were  a  number  of  physical  anomalies  that  are  usually  asso- 
ciated with  hereditary  degeneracy.  Of  these  the  more  worthy  of  note 
are  defectiveness  in  the  form  of  ear,  which  was  found  in  about  50  per 
cent  of  the  cases;  marked  asymmetry  of  face  or  body  12  per  cent; 
markedly  unusual  head  form  six  per  cent ;  speech  defect  two  per  cent. 

A  similar  examination  of  the  girls  at  Adrian  resulted  in  the  follow- 
ing body  of  facts: 

There  were  nine  per  cent  (34)  who  had  irregular  teeth ;  nine  per  cent 
(34)  teeth  noticeably  far  apart;  four  per  cent  (15)  first  teeth;  seven 
per  cent  (28)  decidedly  poor  teeth.  Of  these  whose  teeth  were  in  good 
condition  there  were  10  per  cent   (39). 

Nineteen  per  cent  (74)  of  the  girls  had  either  adenoids  or  enlarged 
tonsils.  Only  about  three  per  cent  had  had  tonsils  or  adenoids  removed. 
Three  per  cent  of  all  the  cases  were  mouth  breathers  and  16  per  cent 
had  defective  palatal  arches. 

Only  two  per  cent  (9)  of  the  girls  had  noticeably  defective  hearing. 
In  at  least  17  per  cent  (64)  of  the  cases  there  was  a  defect  of  the  eye. 
One  per  cent  (4)  wore  glasses,  11  per  cent  (43)  of  the  others  had  de- 
fective vision,  and  four  per  cent  (17)  had  a  strabismus. 

There  were  of  the  386,  13  per  cent  (50)  who  were  slightly  under- 
sized, eight  per  cent  (30)  markedly  undersized,  and  five  per  cent  (19) 
who  were  poorly  nourished  and  anemic. 

The  other  definite  physical  defects  and  diseases  to  be  noted  are  55 
cases  (14%)  of  gonorrhoea*  and  four  cases  (1%)  of  syphilis;  26  per 
cent  (101)  cases  of  thyroid  enlargement;  six  cases  of  chorea. 

Of  the  physical  stigmata  of  degeneracy,  there  were  found  to  be  the 
following:  Defectiveness  of  ear  form  in  about  55  per  cent  of  the  cases; 
definite  facial  or  bodily  asymmetry  in  17  per  cent;  peculiarity  of  head 
shape  seven  per  cent ;  marked  physical  abnormalities  eight  per  cent. 

So  far,  we  have  been  considering  the  totals  for  each  industrial  school. 
These  are  the  facts  which  are  most  to  be  relied  upon.  While  the  per- 
centages concerning  each  of  the  facts  with  which  we  have  just  been  deal- 
ing are  practically  the  same  for  both  the  Normal  and  the  Feebleminded, 
yet  in  relation  to  some  of  the  facts  there  are  rather  striking  dififerences 
between  these  two.  groups. 

Among  the  boys  of  the  Normal  Group,  for  instance,  seven  per  cent 
haA-e  markedly  irregular  teeth,  while  of  the  Feebleminded  Group,  this  per 
cent  is  nearly  double  (13%).  We  find  that  only  seven  per  cent  of  the 
Normal  Group  are  mouth  breathers  as  contrasted  with  16  per  cent  of 
the  Feebleminded  Group.  Among  the  girls,  10  per  cent  of  the  Feeble- 
minded Group  had  their  teeth  abnormally  far  apart,  while  this  was  true 
of  only  six  per  cent  of  the  Normals.  Of  the  Normal  Group  18  per  cent 
had  good  teeth  as  contrasted  with  seven  per  cent  of  the  Feebleminded 
Group. 

Quite  marked  contrasts  are  also  shown  in  the  matter  of  defectively 
formed  ears.  Among  the  boys  such  defects  were  found  in  about  46  per 
cent  of  the  Normals  and  in  about  55  per  cent  of  the  Feebleminded  Group. 
Nearly  the  same  difference  existed  between   the  two  groups  of  girls, 

*  These  facts  at  Adrian  were  obtained  from  the  reports  of  the  physician  at  the  Institution. 


52 

where  there  were  about  47  per  cent  of  the  Normals  as  opposed  to  57  per 
cent  of  the  Feebleminded  with  this  sort  of  defectiveness.  • 

There  were  39  per  cent  of  the  Normal  and  46  per  cent  of  the  Feeble- 
minded boj'S  who  were  undersized  and  anemic.  While  of  the  girls,  there 
were  22  per  cent  of  the  Normal  and  27  per  cent  of  the  Feebleminded. 
Ten  per  cent  of  the  Normal  and  16  per  cent  of  the  Feebleminded  boys 
showed  marked  abnormalities  of  the  face  or  body.  Of  the  girls,  nine  per 
cent  Normal  as  contrasted  with  20  per  cent  feebleminded  had  similar 
asymmetries.  There  was  practically  no  difference  in  the  distribution 
of  the  markedly  peculiar  head  shapes  among  the  two  groups  of  girls.  But 
with  the  hojs  there  were  three  per  cent  of  the  Normals  who  showed  this 
peculiarity  and  10  per  cent  of  the  Feebleminded.  Of  the  six  cases  of 
chorea,  existing  in  the  group  of  girls,  five  were  in  the  Feebleminded  Group. 
Doubtless  these  individuals  were  cases  of  mental  degeneration,  result- 
ing from  the  chorea,  although  it  is  barely  possible  that  they  were  cases 
of  congenital  defectiveness. 

In  reflecting  upon  these  differences  between  the  individuals  of  the 
Normal  and  the  Feebleminded  Groups,  one  is  struck  by  the  fact  that 
they  are  all  differences  in  things  which  are  generally  considered  as 
physical  stigmata  of  degeneracy  and  in  all  cases  the  Feebleminded  have 
markedly  higher  percentages  than  have  the  Normal. 

Occupations. 

Although  the  average  age  at  which  the  delinquents  were  committed  to 
the  industrial  school  was  relatively  low,  13.2  years  for  the  boys  and  14.5 
years  for  the  girls,  yet  the  boys  and  girls  both  had  had  in  a  large  num- 
ber of  cases  more  or  less  varied  experiences  at  wage  earning.  Owing  to 
the  difference  in  the  employments  open  to  the  boys  and  girls,  the  infor- 
mation furnished  by  the  groups  is  not  identical.  Thus  while  it  is  feasible 
to  ascertain  the  wage  of  the  girl  who  has  worked  by  the  week,  it  is  not 
easy  for  a  boy  who  has  been  shining  shoes  or  selling  papers  to  state  his 
average  earnings  per  week.  But  when  it  comes  to  the  kind  of  employ- 
ment in  which  they  have  been  engaged  facts  may  be  obtained  from  each. 
The  facts  concerning  the  occupations  of  the  boys  will  be  discussed  first. 
(See  Table  23.) 

The  thing  which  most  boys  had  done  was  "odd  jobs."  There  were 
57  per  cent  (460)  of  the  809  who  had  at  some  time  or  other  earned  money 
in  this  way.  Of  course,  that  a  large  number  of  boys  at  this  age  should 
have  done  this  sort  of  work  is  to  be  expected.  Yet,  even  if  it  is  to  be  ex- 
pected, it  cannot  but  attract  attention  when  considered  in  relation  to  the 
relatively  small  percentages  of  the  boys  who  had  done  other  definite 
and  well  defined  work.  Aside  from  41  per  cent  who  had  either  sold  or 
delivered  papers,  a  work  not  requiring  that  continuity  of  energy  and 
attention  which  is  demanded  in  a  regular  employment,  and  the  30  per 
cent  who  had  worked  on  farms,  there  were  only  small  percentages  who 
had  done  other  forms  of  work.  The  rather  high  percentage  who  had 
done  farm  work  is  somewhat  misleading  in  that  it  includes  a  good  many 
foreign  boys  who  lived  in  the  city  and  simply  went  out  and  worked 
during  the  summer.  The  more  definite  kinds  of  work  that  had  been  done 
were  delivering  seven  per  cent,  clerking  four  per  cent,  messenger  ser- 
vice four  per  cent,  office  work  two  per  cent  and  factory  work  15  per 
cent.    Briefly  stated,  our  occupational  facts  concerning  the  kind  of  em- 


53 

ployment  show  that  although  many  of  the  boys  had  worked,  few  had 
any  steady,  definite  work.  Of  all  these  boys  who  had  worked,  356  or 
44  per  cent  had  been  either  one  or  more  of  the  following:  Newsboy, 
messenger  boy,  bootblack  or  an  emploj-e  in  show  places.  Sixty,  or  seven 
per  cent  had  been  in  two  of  these  employments.  These  trades  bringing 
the  boy  into  contact  with  the  life  of  the  street  are  often  sources  of  bad 
suggestion.     (See  Table  23.) 

There  are  a  few  kinds  of  employment  in  which  there  is  a  considerable 
difference  in  the  extent  to  which  the  Feebleminded  and  Normal  were 
found.  Thirty-five  per  cent  only  of  the  Feebleminded  had  been  news- 
boys as  contrasted  with  45  per  cent  of  the  Normal.  While,  as  was  pointed 
out  previously,  to  be  a  newsboy  does  not  require  steady  application,  yet 
it  does  require  an  unusual  amount  of  alertness,  at  least  among  those 
selling  on  the  streets  of  the  large  cities.  In  proportion  to  the  actual 
numbers  of  the  two  groups,  there  were  nearly  twice  as  many  among  the 
Normal  (9%)  as  among  the  Feebleminded  (5%),  who  had  been  de- 
livery boys;  and  also  about  twice  as  many  Normals  (5%)  as  Feeble- 
minded (2%),  who  had  been  clerks.  The  fact  that  16  per  cent  more  of 
the  Normal  than  of  the  Feebleminded  Group  had  done  "odd  jobs"  is 
probably  accounted  for  by  the  other  fact  that  the  number  in  the  Normal 
Group  (73%),  who  had  had  more  than  one  occupation  was  much  greater 
than  it  was  in  the  Feebleminded  Group  (53%).  Although  the  average 
number  of  occupations  was  only  slightly  higher  for  the  Normal  (2.5) 
than  for  the  Feebleminded  (2)  yet  over  a  third  more  of  the  Normal  in 
proportion  to  the  actual  numbers  within  the  two  groups  had  done  three 
things,  and  twice  as  many  had  done  four,  while  nearly  twice  as  many 
had  done  five.  This  fact,  together  with  the  small  percentages,  as  already 
noted,  who  had  done  definite  steady  work,  would  seem  to  indicate,  at 
least,  among  the  Normals,  a  tendency  to  instability. 

About  one-half  of  the  girls  at  Adrian  had  either  done  housework 
(40%)  or  had  been  nurse  girls  (8%),  or  had  washed  dishes  (6%).  The 
one  other  kind  of  work  that  had  been  done  most  frequently  by  these  girls 
was  factory  work  (18%).  Eleven  per  cent  had  been  waitresses  and  only 
a  very  few  had  done  other  things.  When  we  look  at  the  question  of  the 
different  number  of  places  worked  in  (See  Table  24),  we  see  an  apparent 
reversing  of  the  conditions  found  among  the  boys.  Only  43  per  cent  of 
the  Normal  Group  as  constrasted  with  47  per  cent  of  the  Feebleminded 
Group  had  worked  in  more  than  one  place.  Stated  in  terms  of  the 
average  number  of  places  worked  in,  the  figure  for  the  Normal  Group  is 
2.8  places  and  that  for  the  Feebleminded  Group  is  3.3  places.  This  ap- 
parent contradiction  is  probably  due  to  the  fact  that  the  occupations  of 
the  boys  were  so  largely  in  positions  without  supervision,  where  in- 
eflSciency  would  not  lead  to  discharge,  while  at  Adrian  there  were  none 
of  this  class.  Also  the  fact  that  so  many  (57%)  of  the  boys,  while  only 
,a  few  (5%)  of  the  girls  did  "odd  jobs,"  would  help  to  make  this  dif- 
ference in  the  two  cases.  Any  number  of  discharges  from  "odd  job" 
positions  would  not  have  been  recorded  as  change  of  position. 

Closely  related  to  the  number  of  places  in  which  the  girls  had  worked, 
are  the  facts  in  regard  to  the  length  of  time  during  which  they  held  their 
position.  Leaving  out  of  consideration  ten  individuals  who  had  worked 
for  room  and  board  and  13  others  who  had  just  worked  during  vaca- 
tions, there  was  a  total  of  248  girls  about  whom  information  was  ob- 


54 

tained  on  this  point.  Nearly  half  of  this  number  (45%)  had  held  their 
position  for  less  than  five  weeks,  while  only  eight  per  cent  had  held  them 
over  30  weeks.  Substantiating  the  fact  that  the  Feebleminded  girls  had 
held  more  positions  than  the  Normal  girls  is  the  fact  that  they  had  re- 
mained in  their  first  positions  for  a  shorter  period  of  weeks. 

Thus  while  it  was  found  that  85  per  cent  of  the  Feebleminded  as  con- 
trasted with  75  per  cent  of  the  Normal  Group  had  stayed  in  the  same 
place  less  than  20  weeks,  when  the  period  of  service  lengthens  to  from 
20  to  29  weeks  there  are  only  eight  per  cent  of  the  Feebleminded  Group 
as  compared  with  13  per  cent  of  the  Normal  who  had  held  their  posi- 
tions. Only  seven  per  cent  Feebleminded  as  contrasted  with  12  per 
cent  Normal  had  worked  over  30  weeks.  The  average  length  of  time 
during  which  those  in  the  Normal  Group  remained  in  their  positions 
was  12.3  weeks  while  the  average  for  the  Feebleminded  Group  was  9.7 
weeks. 

Facts  were  learned  concerning  the  lowest  wage  of  112  girls.  For  nine 
of  these  the  lowest  wage  was  under  $1.00  per  week,  while  for  only  three 
was  it  over  |6.00.  The  largest  per  cent,  (21%)  or  23  cases  received  as 
their  lowest  wage  from  $2.50  to  $3.00  per  week.  The  average  lowest 
wage  was,  roughly,  $2.50. 

In  the  cases  of  173  girls,  facts  were  learned  concerning  the  highest 
wage  which  they  received.  The  highest  wage  of  three  girls  was  less 
than  $1.00  per  week  while  for  only  seven  was  it  over  $9.00  and  one  of 
these  seven  was  a  professional  prostitute.  The  largest  per  cent  of  the 
girls  (18%)  or  32  cases  received  from  $3.00  to  $4.00.  The  approximate 
average  highest  wage  received  by  these  173  girls  was  $4.50. 

Evidence  of  the  inferior  capacity  of  the  girls  in  the  Feebleminded 
Group  is  found  by  comparing  the  average  lowest  and  the  highest  wages 
of  these  girls  with  those  of  the  Normal  girls.  The  approximate  average 
lowest  wage  of  the  girls  in  the  Normal  Group  was  $3.20,  while  that  of 
the  Feebleminded  Group  was  $2.40.  The  approximate  average  highest 
wage  for  the  girls  in  the  Normal  Group  was  $5.23  while  that  for  those 
in  the  Feebleminded  Group  was  $4.07. 

Delinquent  Record. 

Only  the  more  striking  points  in  the  delinquent  records  of  the  inmates 
of  the  two  schools  will  be  touched  upon  here.  Those  who  are  interested 
in  this  particular  phase  of  the  subject  will  find  the  detailed  results  of 
the  investigation  in  Table  25  of  the  Appendix. 

It  is  interesting  to  note  that  of  the  boys  now  at  Lansing  less  than  one- 
fourth  (23%)  as  opposed  to  one-half  (47%)  of  the  girls  now  at  Adrian 
were  sent  there  upon  their  first  offense.*  The  other  principal  treat- 
ments meted  out  for  first  offenses  were  probation — boys  32  per  cent, 
girls  10  per  cent;  cases  dismissed — boys  20  per  cent,  girls  nine  per  cent. 
It  will  be  noticed  that  the  treatment  of  the  girls  upon  their  first  offense 
was  much  more  severe  than  was  that  of  the  boys. 

A  possible  explanation  of  this  may  be  found  in  the  fact  that  in  the 
eyes  of  the  law  the  sex  offenses  of  the  girls  (32%  being  committed  for 
these)  are  considered  more  serious  than  the  offenses  of  larceny  (44%) 
and  truancy  (31%)  for  which  the  boys  were  largely  brought  into  court. 

•Whenever  "first  offense"  Is  mentioned,  the  first  offense  which  brought  the  subject  into  con- 
tact with  the  law  Is  meant. 


55 

The  sex  offenses  of  the  girls  consisted  largely  of  illicit  intercourse  and 
the  boy  in  the  case  was  seldom,  if  ever,  brought  before  the  court.  As  a 
matter  of  fact  37  per  cent  of  the  229  older  boys  at  Lansing,  about  whom 
facts  were  gained,  as  against  68  per  cent  of  the  total  girls  at  Adrian 
had  had  illicit  intercourse.  So  although  the  double  standard  of  mor- 
ality accounts  for  the  greater  number  of  girls  being  brought  before  the 
court  for  sex  offenses,  it  is  no  doubt  the  character  of  this  offense  which 
explains  the  fact  of  the  girls  receiving  more  serious  treatment  for  their 
first  offense. 

This  difference  between  the  character  of  the  offenses  committed  by  the 
boys  and  girls  probably  also  explains  why  there  are  so  many  more  boys 
with  a  large  number  of  delinquencies  reported  against  them.  Thirty-three 
per  cent  of  the  boys  had  been  delinquent  twice,  21  per  cent  three  times,  10 
per  cent  four  times  and  about  eight  per  cent  over  four  times.  Only  26 
per  cent  of  the  girls,  had  been  delinquent  twice,  seven  per  cent  three 
times,  two  per  cent  four  times  and  about  three  per  cent  more  than  four 
times.  Of  course,  a  girl  might  have  committed  any  number  of  sexual 
offenses  and  yet  have  been  discovered  and  brought  into  court  only  once, 
while  a  boy  more  frequently  breaking  into  freight  cars,  committing  petty 
larceny,  and  playing  truant  would  be  caught  and  brought  before  the 
authorities  much  more  frequently. 

The  causes  for  which  the  boys  were  actually  committed  to  Lansing 
correspond  very  closely  to  the  causes  for  which  they  were  first  brought 
before  the  authorities.  There  are  still  nearly  three-fourths  in  which  the 
cause  is  either  larceny  (53%)  or  truancy  (17%),  although  it  will  be 
seen  that  the  proportion  between  the  two  offenses  has  varied,  giving 
larceny  a  much  more  marked  preponderance.  With  the  girls,  also,  there 
is  practically  no  difference  between  the  character  of  their  first  offenses 
and  the  character  of  those  offenses  which  caused  their  first  commitment. 

The  one  other  aspect  of  the  delinquent  histories  of  the  boys  and  the 
girls  that  is  of  especial  interest  in  this  connection  is  that  dealing  with 
the  total  number  of  institutions  in  which  they  had  been  resident  subse- 
quent to  their  first  offense.*  (See  Table  26.)  Of  the  total  809  boys, 
one-fourth  had  been  in  one  or  more  institutions,  either  correctionary  or 
charitable,  22  per  cent  had  been  in  one  or  more  correctionary  institu- 
tions,** (15%  in  one  and  8%  in  more  than  one),  and  four  per  cent  in 
one  or  more  non-correctionai-y  institutions. 

Nearly  as  high  percentages  are  found  among  the  girls  which  is 
particularly  striking  when  it  is  recalled  that  nearly  twice  as  many  girls 
as  boys  were  sent  directly  to  the  industrial  school.  There  were  24  per 
cent  of  the  girls  who  had  been  resident  in  one  or  more  institutions, 
either  correctionary  or  charitable;  18  per  cent  who  had  been  in  one  or 
more  correctionary  institution,**  (15%  in  one  and  3%  in  more  than 
one),  and  seven  who  had  been  in  one  or  more  non-correctionary  insti- 
tutions. 

Habits. 

There  is  perhaps  no  more  striking  group  of  facts  in  all  the  material 
which  was  obtained  concerning  the  individual  histories  of  the  juve- 
nile delinquents  than  that  recording  their  habits,  and  especially  their 
sex  habits.     (See  Table  27.) 

*In  giving  these  numbers,  the  present  residence  at  the  Industrial  School  is  not  considered. 
••Including  Detention  Home. 


5C 

For  the  girls  there  were  two  ways  in  which  the  material  concerning 
sex  habits  was  obtained.  The  commitment  papers  furnished  evidence 
and  the  girls  themselves  admitted  much  to  the  investigators.  Of  the  386 
girls,  151  or  39  jier  cent  were  committed  for  sex  offenses,  while  27  or 
seven  per  cent  more  were  committed  for  sex  offenses  together  with  other 
offenses,  especially  truancy  and  larceny.  This  means  that  of  all  the 
girls  committed  there  were  46  per  cent  in  which  the  sex  offenses  were  the 
sole  or  partial  cause  for  their  commitment. 

From  the  statements  of  the  girls  themselves,  it  was  learned  that  263 
or  68  per  cent  of  the  386  had  had  sexual  intercourse.  Thirty-eight  per 
cent  of  the  total  number  of  girls  had  had  intercourse  with  from  one  to 
three  different  individuals,  and  20  per  cent  with  more  than  three  indi- 
viduals. 

The  various  facts  which  we  were  able  to  obtain  tended  to  show  that 
the  girls  in  the  Feebleminded  Group  were  more  sexually  irresponsible 
than  were  those  of  the  Normal  Group.  Sexual  offenses  were  the  partial 
or  sole  causes  for  the  commitment  of  48  per  cent  of  the  girls  in  the 
Feebleminded  Group  as  contrasted  with  42  per  cent  of  the  girls  in  the 
Normal  Group.  More  of  the  Normal  Group  (41%)  than  of  the  Feeble- 
minded Group  (38%)  had  had  intercourse  with  from  one  to  three  dif- 
ferent individuals.  However,  when  it  comes  to  the  percentages  of 
those  who  had  had  intercourse  with  more  than  three  individuals  we 
find  that  there  were  21  per  cent  of  the  girls  of  the  Feebleminded  Group 
and  16  per  cent  of  those  of  the  Normal  Group.  Taken  altogether,  71 
per  cent  of  the  Feebleminded  Group  had  had  illicit  intercourse  as  compar- 
ed with  63  per  cent  of  the  Normal  Group.  The  contrast  between  the  num- 
bers of  the  two  groups  is  particularly  marked  in  relation  to  the  num- 
bers who  were  guilty  of  incest.  There  were  six  of  the  Normal  girls  as 
opposed  to  31  of  the  Feebleminded  who  were  guilty  of  this  form  of 
sexual  irregularity. 

No  adequate  data  was  obtained  concerning  the  extent  to  which  the 
girls  smoked  or  used  drugs,  nor  the  extent  to  which  they  practiced  self- 
dbuse.  The  facts  regarding  the  use  of  alcohol  can  be  very  briefly  stated. 
Of  the  386,  there  were  17  per  cent  (64)  who  had  drunk. 

The  question  of  sex  habits  as  it  was  studied  among  the  boy  delin- 
quents was  quite  a  different  problem  than  was  the  same  question  as 
studied  among  the  girl  delinquents.  In  only  a  very  few  cases  did  sexual 
offenses  appear  as  the  cause  of  commitment.  There  were  two  boys  com- 
mitted for  sodomy,  two  for  rape,  and  four  for  taking  improper  liberties 
with  a  female  child.  When  it  is  remembered  that  there  were  809  boys, 
whose  commitment  records  were  studied,  it  will  be  seen  how  relatively 
unimportant  sex  offenses  were  as  the  direct  cause  of  commitment.  How- 
ever, even  though  sex  habits  did  not  appear  as  direct  factors  in  the 
commitment  of  the  boys,  the  facts  obtained  would  indicate  that  they 
had  an  unquestionable  influence  upon  their  lives. 

The  entire  study  at  Lansing  was  undertaken  by  two  people,  a  man 
investigator  and  a  woman  investigator.  It  was  felt  that  it  would  be 
difficult  for  a  woman  to  successfully  obtain  information  concerning  the 
sex  habits  of  boys  of  this  age.  Therefore,  no  attempt  was  made  to  ascer- 
tain such  facts  concerning  the  boys  with  whom  the  woman  investigator 
worked.  Consequently  all  the  facts  obtained  on  this  question  were  from 
the  group  of  boys  with  whom  the  man  investigator  worked.    This  group 


57 

included  229  bo.ys,  most  of  whom  were  of  the  older  class  of  boys  (only 
15  were  under  13  years  of  age) .  These,  therefore,  as  a  rule,  were  those 
who  had  had  a  more  extensive  delinquent  and  sexual  experience.  The 
investigation  was  conducted  by  one  experienced  in  dealing  with  boys. 

The  sex  habits  of  the  boys  were  masturbation,  sodomy  and  normal 
intercourse  with  the  opposite  sex.  Of  the  229  boys  in  the  group  about 
which  sex  facts  were  obtained,  25%  (59)  had  practiced  sodomy.  There 
were  two-thirds  (153)  who  had  indulged  in  the  practice  of  masturbation. 
Eighty-five  or  37  per  cent  of  these  boys  had  had  illicit  intercourse.  Of 
these  85  there  were  11  who  had  been  in  houses  of  prostitution,  four  who 
had  had  intercourse  with  their  sisters,  while  three  had  had  intercourse 
with  cousins.  Seven  per  cent  (17)  of  the  boys  had  practiced  both 
sodomy  and  masturbation  and  also  had  had  sexual  intercourse.  There 
were  21.18  per  cent  who  had  practiced  both  sodomy  and  masturbation. 
Of  the  entire  group,  there  was  nearly  three-fourths  (1G3),  71  per  cent, 
who  had  practiced  either  sodomy,  masturbation,  or  both,  while  of  those 
who  had  either  practiced  sodomy,  had  had  intercourse  with  the  opposite 
sex,  or  had  masturbated  there  were  76  per  cent  (174). 

Comparing  the  boys  in  the  Normal  and  Feebleminded  Groups,  it  was 
found  that  those  sex  habits  which  were  perversions  of  the  natural  ex- 
pression of  the  sex  instinct  existed  more  largely  among  the  members  of 
the  Feebleminded  Group  than  among  those  of  the  Normal  Group.  Thus 
29  per  cent  (24)  of  the  82  boys  in  the  Feebleminded  Group  compared 
with  24  per  cent  (35)  of  the  147  boys  in  the  Normal  Group  had  prac- 
ticed sodomy  and  73.14  per  cent  (60)  of  the  Feebleminded  Group  as 
compared  with  63  per  cent  (93)  of  the  Normal  Group  had  practiced 
masturbation.  Even  when  it  comes  to  the  question  of  expressing  the 
sexual  instinct  in  the  normal  though  illicit  intercourse  with  the  opposite 
sex,  the  Feebleminded  slightly  exceeded,  except  in  the  matter  of  exces- 
sive intercourse,  those  of  the  Normal  Group.  Thus  of  the  147  in  the  Nor- 
mal Group  there  were  36  per  cent  who  had  had  intercourse,  while  in 
The  Feebleminded  Group  there  were  39  per  cent.  However,  18  per 
cent  of  the  Normal  Group  had  had  intercourse  more  than  three  times  as 
opposed  to  16  per  cent  of  the  Feebleminded  Group.     (See  Table  27.) 

Data  concerning  the  extent  to  which  the  boys  used  tobacco  and  alcohol 
was  obtained  by  both  investigators.  Therefore,  the  percentages  given 
in  relation  to  these  habits  apply  to  the  entire  group  of  809  boys.  There 
were  581  or  71  per  cent  of  these  who  had  smoked.  Of  this  number  113 
had  smoked  excessively.  Two  hundred  seventy-seven  or  34  per  cent  of 
the  boys  chewed ;  30  of  these  had  chew  ed  since  they  had  been  in  the  institu- 
tion. Of  the  809  boys,  273  or  34  per  cent  had  used  alcoholic  beverages. 
There  were  105  or  13  per  cent  who  had  been  drunk  one  or  more  times. 

There  was  practically  no  difference  in  the  proportion  of  the  Normal 
and  the  Feebleminded  who  smoked,  although  the  practice  of  chewing 
was  more  prevalent  among  the  boys  of  the  Feebleminded  Group,  there 
being  39  per  cent  of  the  group  who  did  it,  as  opposed  to  31  per  cent  of 
those  in  the  Normal  Group.  A  very  interesting  contrast  is  shown  in 
the  percentages  of  the  two  groups  who  have  chewed  since  they  had  been 
in  the  institution.  There  were  five  per  cent  of  th€  Normal  Group  boys 
who  had  been  successful  enough  to  escape  the  vigilance  of  the  authorities 
and  obtain  tobacco,  while  there  were  only  two  per  cent  of  tjie  boys  in  the 
Feebleminded  Group  who  had  been  equally  successful.     There  was  very 


58 

little  difference  also  in  the  extent  to  which  the  two  groups  had  used 
alcohol. 

Other    Facts. 

There  are  a  few  more  facts  to  be  considered  in  relation  to  the  general 
conditions,  which  may  have  had  a  bearing  upon  the  delinquencies  of 
the  children  in  the  two  industrial  schools. 

There  were  relatively  few  of  either  the  boys  (12%,  92  cases)  or  of 
the  girls  (8%,  20  cases)  who  were  born  in  foreign  countries.  Of  the 
foreign  born  boys,  the  largest  number  were  born  in  Canada  (13)  and 
Poland  (33).  The  largest  number  of  the  foreign  born  girls  were  from 
Canada  (22).  Seventy-three  per  cent  (593)  of  all  the  boys  and  76  per 
cent  (294)  of  all  the  girls  were  born  in  Michigan.    (See  Table  28.) 

Even  though  the  majority  of  the  children  themselves  were  native  born» 
there  was  a  large  number  of  the  parents  who  were  foreign  born.  Of  all 
the  fathers  and  mothers  of  the  boys,  42  per  cent  were  foreign  born 
while  of  all  those  of  the  girls  27  per  cent  were  foreign  born.  Thirty-six 
per  cent  of  the  boys  and  18  per  cent  of  the  girls  were  of  foreign 
parentage.  Twelve  per  cent  more  of  the  boys  and  19  per  cent  more  of 
the  girls  were  of  foreign  or  mixed  parentage  and  26  per  cent  of  the 
boys  and  30  per  cent  of  the  girls  were  of  pure  native  parentage.  .  (See 
Table  29.) 

It  is  to  be  seen,  therefore,  that  while  the  number  of  foreign  born 
children  in  the  industrial  schools  is  relatively  small,  yet  a  large  pro- 
portion of  them  (48%  of  the  boys  and  37%  of  the  girls)  were  of  foreign 
or  partially  foreign  extraction.  This  fact  may  have  an  important  bear- 
ing upon  the  child's  development.  It  may  oftentimes  mean  an  inability 
of  the  parents  to  grasp  sufficiently  the  new  environment  into  which 
they  have  come,  to  enable  them  to  guide  their  children  in  the  problems 
which  this  environment  presents  to  them. 

The  number  of  times  a  child  has  moved  from  one  place  to  another 
may  be  doubly  significant.  It  may  be  indicative  of  instability  on  the 
part  of  the  parents.  Very  frequent  moves  may  also  mean  that  the  child 
does  not  have  a  chance  to  adequately  readapt  itself  to  the  changed 
environment.  This  is  frequently  a  factor  contributing  to  his  delinquency. 
The  failure  of  quick  readjustment  to  the  new  conditions  which  the  indi- 
vidual is  forced  to  meet  may  cause  a  conflict  with  the  law  by  a  mere 
failure  to  understand  the  customs  of  law  enforcement  in  the  new  com- 
munity. Thus,  a  boy  may  move  from  a  district  where  the  policeman  is 
genial  and  does  not  enforce  the  ordinance  against  riding  a  bicycle  on 
the  sidewalk  to  another  district  of  the  same  city  in  which  the  policeman 
is  surly  and  does  enforce  this  ordinance. 

Information  concerning  the  number  of  times  that  the  individual  has 
moved  was  obtained  in  all  but  a  few  cases  (one  per  cent  of  the  girls  and 
seven  per  cent  of  the  boys).  Only  five  per  cent  of  the  boys  and  three 
per  cent  of  the  girls  had  always  lived  in  the  same  place,  while  about 
one-fourth  of  each  had  lived  in  four  or  five  different  places,  and  about 
15  per  cent  more  of  the  boys  and  30  per  cent  more  of  the  girls  had  lived 
in  more  than  five  places.  About  one-third  of  the  boys  and  one-fourth 
of  the  girls  had  lived  in  only  one  city,  while  nearly  two-fifths  of  both 
boys  and  girls  had  lived  in  two  or  three  different  cities,*    nearly  one- 

•A  city  lived  In  at  two  or  more  different  times  was  counted  as  two  or  more  cities. 


59 

fifth  in  four  or  five,  and  about  six  per  cent  of  the  boys  and  10  per  cent 
of  the  girls  in  over  five  cities.     (See  Table  30.) 

Family  Facts. 

So  far,  we  have  been  presenting  data  relating  very  directly  to  the 
history  and  character  of  the  individuals  themselves.  We  now  turn  to 
a  consideration  of  the  data  that  pertains  to  the  relatives  and  to  the 
family  life  of  these  same  individuals.  Though  the  data  obtained  is  not 
as  complete  as  could  be  wished,  it  is  suflSciently  striking  to  indicate 
important  relations  to  the  delinquencies  and  mentalities  of  the  inmates 
in  the  industrial  schools. 

No  definite  attempt  was  made  to  obtain  information  concerning  the 
occupations  of  the  fathers  and  mothers  of  the  Adrian  girls.  Such  an 
attempt  was,  however,  made  in  the  work  at  Lansing.  The  most  inter- 
esting thing  shown  by  the  facts  concerning  the  occupations  of  the  boys' 
fathers  is  the  greater  proportion  of  the  fathers  of  the  boys  in  the  Feeble- 
minded Group  who  were  doing  unskilled  work.     (See  Table  32.) 

There  were  221  fathers  of  the  boys  in  the  Feebleminded  Group  about 
whom  occupational  facts  were  definitely  enough  known  to  classify  their 
occupation  as  either  skilled  or  unskilled.  Of  these  57,  or  only  26  per 
cent,  were  doing  skilled  work,  while  164,  or  74  per  cent,  were  doing  un- 
skilled work.  Similar  occupational  facts  were  known  about  375  fathers 
of  the  boys  of  the  Normal  Group.  Of  these  44  per  cent  were  doing 
skilled  work  while  56  per  cent  were  doing  unskilled  work. 

Of  the  mothers  of  the  809  boys,  it  is  definitely  known  that  at  least 
339  contributed  to  the  support  of  the  family  by  wage  earning.  Two- 
thirds  of  all  the  mothers  who  did  wage  earning  work  (or  17  per  cent  of  all 
the  mothers)  did  it  at  home,  largely  in  the  form  of  washing.  There  were 
nearly  as  many  of  all  the  mothers  (15  per  cent)  who  did  work  which 
took  them  away  from  the  home  at  least  a  part  of  the  time.  This  num- 
ber consists  largely  of  those  who  did  general  housework  by  the  day  or 
week.  There  were  nearly  six  per  cent  of  all  the  mothers  who  did  work 
such  as  in  factories,  stores,  or  hotels,  which  kept  them  away  from  home 
all  day.     (See  Table  33.) 

Other  facts  were  learned  about  the  parents  of  both  the  boys  and  girls 
of  the  industrial  schools.     (See  Tables  34  and  35.) 

There  were  20  of  the  parents  of  the  Adrian  girls  who  had  been  in  jail, 
11  in  State  Prison,  five  in  the  House  of  Correction,  one  in  Lansing  and 
two  in  Adrian.  Of  the  total  386  fathers  of  these  girls  47  per  cent  (183) 
were  users  of  alcoholic  beverages,  10  per  cent  being  excessive  drinkers. 
The  extent  to  .which  the  other  37  per  cent  drank  is  unknown.  Six  of 
the  fathers  were  in  State  Prison  for  sex  offenses.  Forty-six  of  the  mothers 
drank  to  some  extent,  nine  of  the  mothers  were  prostitutes. 

Of  the  total  386  families  14  per  cent  had  received  help  from  the  city 
or  county.  Only  nine  per  cent  of  the  families  of  the  girls  in  the  Normal 
Group,  as  contrasted  with  16  per  cent  of  those  in  the  Feebleminded 
Group,  had  received  such  help. 

One  hundred  six  of  the  Lansing  boys'  parents  had  been  in  jail,  25 
in  the  House  of  Correction,  seven  in  State  Prison  and  two  in  Adrian. 
There  were  422,  or  52  per  cent,  of  the  fathers  of  the  809  boys  who 
drank,  20  per  cent  excessively.  Fifty-seven  of  the  mothers  of  the  boys 
drank. 


CO 

Of  the  809  families,  131,  or  10  per  cent,  had  had  help  from  the  city  or 
count}'.  Twenty-two  per  cent  of  the  families  in  the  Feebleminded  Group 
as  contrasted  wuth  12  per  cent  of  the  families  in  the  Normal  Group. 

Equally  interesting  with  the  parental  facts,  at  least  in  relation  to 
institutional  records,  are  those  concerning  the  fraternities  of  the  boys 
and  girls.  In  37  instances  there  were  two  brothers,  and  in  one  instance 
three  brothers,  in  Lansing  at  the  time  this  study  was  made.  From  the 
fraternities  of  all  the  boys  there  were  59  others  who  had  at  some  previ- 
ous time  been  at  Lansing,  and  25  who  had  been  at  the  Adrian  Industrial 
Home.  Forty-eight  members  of  the  fraternities  of  these  boys  had  been 
in  jail,  11  in  the  House  of  Correction  and  eight  in  State  Prison ;  39  had 
been  in  the  State  Public  School  at  Coldwater,  two  in  insane  hospitals, 
and  six  in  Lapeer.     Forty-two  had  been  in  private  orphan  asylums. 

Among  the  girls  studied  at  Adrian  there  were  eight  instances  of  two 
sisters  and  one  of  three.  There  were  14  other  sisters  of  the  Adrian  girls 
who  had  been  at  Adrian  and  40  of  their  brothers  who  had  been  at  the 
I^nsing  Industrial  School.  There  were  also  12  members  of  their  fra- 
ternities who  had  been  in  State  Prison.  There  were  34  who  had  been 
in  the  State  Public  School,  13  in  private  orphan  asylums,  three  in  Lapeer 
and  two  in  insane  hospitals. 

Of  the  other  relatives  of  the  boys  there  were  40  who  had  been  in 
jail,  nine  in  State  Prison,  45  in  one  of  the  industrial  schools,  six  in 
Lapeer,  nine  in  the  State  Public  School,  and  12  in  hospitals  for  the  in- 
sane. Of  the  other  relatives  of  the  girls,  there  were  seven  who  had  been 
in  jail,  eight  in  State  Prison,  28  in  one  of  the  industrial  schools,  three 
in  Lapeer,  one  in  the  State  Public  School  and  four  in  insane  hospitals. 


In  this  connection,  it  is  worthy  of  note  that  both  at  Lansing  and 
Adrian  the  children  who  came  from  the  largest  families  were  the  chil- 
dren who  were  in  the  Feebleminded  Group.     (See  Table  36). 

At  Lansing  the  difference  is  only  slight.  Twenty-seven  per  cent  of  the 
boys  of  the  Normal  Group  came  from  families  of  one  to  three  children, 
16  per  cent  from  families  of  four  children  and  55  per  cent  from  families 
of  more  than  four  children.  Of  the  boys  in  the  Feebleminded  Group, 
24  per  cent  came  from  families  of  from  one  to  three  children,  16  per 
cent  from  families  of  four  children,  and  56  per  cent  from  families  of 
more  than  four  children. 

The  figures  for  Adrian  show  a  more  marked  difference.  There  were 
coming  from  families  of  from  one  to  three  children,  40  per  cent  of  the 
girls  in  the  Normal  Group  and  22  per  cent  of  those  in  the  Feebleminded 
Group ;  coming  from  families  of-  four  children,  Normal  Group  16  per 
cent,  Feebleminded  Group,  12  per  cent;  coming  from  families  of  more 
than  four  children.  Normal  Group  41  per  cent;  Feebleminded  Group 
64  per  cent. 

The  average  number  of  children  from  which  the  girls  of  the  Normal 
Group  came  was  4.6.  That  from  which  the  Feebleminded  Group  girls 
came  was  six.  However,  the  boys  of  the  Normal  Group  came  from  fami- 
lies with  an  average  of  5.2  children,  while  those  of  the  Feebleminded 
Group  came  from  families  of  only  a  slightly  higher  average  number  of 
children,  5.4. 


61 

Civil  Condition  of  Parents. 

A  very  definite  body  of  facts  was  obtained  regarding  the  civil  condi- 
tion of  the  parents  of  the  inmates  of  the  Lansing  and  Adrian  schools. 
The  facts  were  ascertained  for  all  the  parents  of  the  boys  with  the  small 
exception  of  about  four  per  cent  of  the  cases,  and  for  the  parents  of  the 
girls  in  all  but  about  seven  per  cent  of  the  cases.     (See  Table  38.) 

Of  the  families  of  the  809  boys  there  were  only  42  per  cent  and  of 
the  families  of  the  386  girls  only  26  per  cent  in  which  both  the  parents 
were  living  and  living  together.  There  were  233,  or  over  a  fourth,  of  the 
families  from  which  the  boys  came  and  150,  or  two-fifths,  of  the  families 
from  which  the  girls  came  that  had  been  broken  up  by  the  death  of  on^ 
parent.  Practically  the  same  number  of  fathers  died  as  of  mothers. 
There  were  nearly  three  per  cent  of  both  the  boys  and  the  girls  who 
had  lost  both  parents.  Sixteen  per  cent  of  the  parents  of  the  boys  and 
eighteen  per  cent  of  the  parents  of  the  girls  were  either  separated  or 
divorced.  Six  per  cent  of  the  families  from  which  the  boys  came  and 
seven  per  cent  of  those  from  which  the  girls  came  had  been  broken  up 
by  desertion.  The  total  number  of  desertions  for  both  boys  and  girls 
was  78.  Of  these  78  cases,  the  desertion  was  on  the  part  of  the  father 
in  59  instances  and  on  the  part  of  the  mother  in  19. 

Definite  as  these  facts  are,  no  unequivocable  conclusions  can  be  drawn 
from  most  of  them.  Perhaps  the  cases  in  which  the  destruction  of  the 
family  is  most  probably  detrimental  to  the  child  is  when  that  destruc- 
tion is  caused  by  death.  In  many  cases,  the  death  of  the  father  means 
not  only  the  removal  of  a  beneficial,  oftentimes  even  a  necessary,  influ- 
ence to  the  successful  rearing  of  the  child,  but  also  by  removing  a  source 
of  income  means  a  lessened  opportunity  for  normal  development  both 
intellectually  and  physically.  The  increased  financial  strain  may  force 
the  mother  to  devote  so  much  of  her  time  to  wage  earning  as  to  cause 
a  neglect  of  the  equally  necessary  but  less  coercive  duties  of  child  train- 
ing. The  child,  even,  may  be  forced  to  assume  its  share  in  the  main- 
tenance of  the  family  and  this,  before  its  physical  maturity,  and  at  a 
time  when  it  should  be  preparing  for,  rather  than  taking  an  active  part 
in,  the  economic  life  of  society.  The  death  of  the  mother  probably,  in 
general,  means  the  removal  of  the  more  efficient  instrument  in  the  care 
of  the  children.  In  regard  to  the  parent  who  has  deserted  his  family 
the  presumption  is  that  the  general  conditions  of  the  family  are  but  little 
different  after  the  desertion.  The  deserting  parent  has  probably  never 
contributed  much,  either  in  good  training  or  efficient  financial  support. 

It  should  also  be  remembered  that  many  of  the  parents  who  died 
had  criminal  records,  used  alcohol  excessively  or  were  otherwise  im- 
moral. Perhaps,  then,  the  removal  of  this  parent  may  not  have  been 
in  the  nature  of  a  deprivation.  Another  fact  tends  to  complicate  the 
situation.  Of  all  those  families  which  were  broken  up  by  the  death  of 
either  parent,  nearly  one-half  (48%)  were  remarried.  These  remar- 
riages may  or  may  not  have  relieved  the  economic  situations  which  need- 
ed relief  and  they  may  or  may  not  have  introduced  desirable  influences 
upon  the  children. 

When  we  come  to  the  consideration  of  the  families  which  were  broken 
up  by  separation  or  divorce,  we  are  even  less  sure  of  our  ground.  It 
is  quite  as  possible  that  the  separation  of  members  uncongenially  mated 
would  be  better  for  the  child  than  the  continuation  of  such  a  relation- 


62 

ship.  However,  it  is  probabh'  safe  to  assume  that,  in  nearly  all  of  the 
families  in  which  the  parents  separated,  at  some  period  of  the  life  of 
the  child  it  was  under  the  influence  of  a  home  environment  lacking  in 
the  harmony  of  even  the  ordinary  home.  There  can  be  no  doubt  that  a 
child's  character  suffers  under  an  atmosphere  of  familj'  contention  and 
discord. 

Pains  have  been  taken  to  suggest  the  impossibility  of  taking  too  much 
for  granted  in  relation  to  the  statistics  regarding  the  immense  number 
of  cases  in  which  the  families  of  delinquent  children  had  been  broken  up. 
This  has  been  done  because  of  the  feeling  that  such  statistics  are  too 
often  quoted  as  expressing  a  condition  unquestionably  bad  in  its  influ- 
ence upon  the  child.  It  cannot  be  too  strongly  urged  that  such  figures 
as  we  have  given  can  do  but  little  more  than  indicate  a  source  of  weak- 
ness in  the  environment  of  the  developing  child.  Absolute  facts  could 
only  be  stated  after  an  intimate  study  of  the  home  conditions  both  be- 
fore and  after  the  change  in  the  civil  conditions  of  the  parents. 


FEEBLEMINDEDNESS  IN  RELATION  TO  DEPENDENCY. 

Introduction. 

The  Commission  attempted  to  make  a  study  of  all  the  people  in  the 
79  County  Infirmaries  of  the  State.  Two  of  the  Commission's  investi- 
gators were  detailed  for  this  purpose.  Each  infirmary  was  visited  by 
one  or  both  of  these  investigators. 

The  primary  object  of  the  investigation  was  to  determine  the  mental 
status  of  the  people  in  the  County  Infirmaries.  In  connection,  however, 
with  the  study  required  for  this  purpose,  an  attempt  was  made  to  gain 
as  much  and  as  varied  information  as  possible.  It  was  hoj^ed  that  by 
so  doing  some  additional  light  might  be  thrown  upon  the  problem  of  de- 
pendency or  upon  the  problems  connected  with  the  insane  or  the  de- 
fective. 

Most  of  the  data  which  the  investigators  obtained  did  have  a  direct 
bearing  upon  these  problems.  This  data  will  be  discussed  here,  in  the 
body  of  the  report.  In  the  detailed  tables  of  the  Appendix  will  be  found 
not  only  the  figures  upon  which  this  discussion  is  based,  but  also  those 
facts  which  had  only  a  more  indirect  bearing  upon  the  questions  dis- 
cussed. 

While  the  total  number  of  individuals  taken  care  of  in  the  County 
Infirmaries  during  the  fiscal  year  ending  June  30th,  1913,  was  over  7,000, 
the  average  number  of  individuals  reside;it  in  the  infirmaries,  during 
this  period,  was  only  about  3,600.  Even  a  considerable  portion  of  this 
average  population  was  a  transient  population.  The  facts  obtained  dur- 
ing the  course  of  the  investigation  undertaken  by  this  Commission  do 
not  embrace,  then,  the  information  concerning  the  total  number  of  in- 
dividuals resident  in  the  infirmaries  during  one  year.  Information  was 
only  obtained  concerning  those  individuals  who  happened  to  be  resident 
at  each  infirmary  at  the  time  that  the  infirmary  was  visited  by  the  in- 
vestigator.   The  period  during  which  this  study  at  the  infirmaries  was 


63 

being  carried  on  extended  from  July,  1913,  to  September,  1914.    During 
this  period  3,334  residents  of  the  County  Infirmaries  were  studied. 

Mental  Status. 

The  mental  classification  of  these  3,334  individuals  will  be  first  con- 
sidered.    The  problem  confronting  the  investigator  was  the  determina- 

MAP  IE. 


tion,  after  a  brief  interview  and  study,  of  the  mental  status  of  each 
individual.  By  far  the  largest  number  of  cases  could  be  clearly  classi- 
fied as  Normal,  Neurotic,  Feebleminded,  Epileptic  or  Insane.  There 
were,  however,  a  number  of  cases,  which  though  unquestionably  mental- 
ly aberrated,  could  not  be  definitely  classed  as  either  feebleminded  or 


64 

insane  without  a  more  detailed  history  than  was  obtainable.  In  this 
jyroup  were  those  individuals  who  might  have  been  either  advanced 
dementia  praecox  cases,  or  cases  of  congenital  feeblemindedness.  In 
this  group  were  also  those  individuals  whose  mental  condition  either 
may  have  been  due  to  the  deterioration  accompanying  senile  changes 
or  may  have  been  an  inherited  defectiveness.    All  of  these  cases  which 

MAP  IV. 


DOMINION     OF    CANADA 


I  LLl  N  0   I  $ 


C  n  t  c  At* 


may  have  been  either  insane  or  feebleminded,  were  designated  as  X  men- 
tality. There  was  a  very  small  group  of  individuals  whose  mental  con- 
dition it  was  impossible  to  classify.  These  individuals  were  called  of 
Questionable  mentality.  In  this  group  were  very  young  children,  those 
individuals  of  foreign  birth  who  could  not  understand  English  and  for 


65 

whom  no  interpreter  could   be  obtained,  and  those  individuals  whose 
physical  condition  made  it  impossible  to  interview  them. 

On  this  basis  of  classification  58  per  cent  (1937)  of  the  3,334  County 
Infirmary  inmates  were  Normal;  one  per  cent  (37)  were  Neurotic;  21 
per  cent  (710)  were  Feebleminded;  12  per  cent  (407)  were  Insane;  two 
per  cent  (81)  were  of  X  mentality,  and  nearly  1.5  per  cent  (48)  were 
of  Questionable  mentality.     (See  Table  38.) 

N/IAPV 


DOMINION     OF    CANADA 


I LLI  N  0   IS 


Summarized,  these  figures  show  that  of  the  total  3,334  people  in  the 
County  Infirmaries  nearly  two-fifths  (39%)  are  either  insane  or  mental- 
ly defective.    In  giving  this  percentage  and  throughout  the  body  of  the 
report,  as  well  as  in  the  Appendix,  whenever  reference  is  made  to  the 
9 


66 

Insane  and  Defective  Group,  there  are  included  those  who  were  either 
Insane,  Feebleminded,  Epileptic,  or  of  X  mentality.  When  the  Normal 
Group  is  referred  to,  there  are  included  all  cases  of  Normal  mentality 
and  the  37  cases  who  were  merely  neurotic.  The  few  cases  in  the  class 
of  Questionable  mentality  will  not  be  discussed  separately. 

In  Map  III  is  shown  for  each  County  Infirmary  the  proportion  of  its 
population  that  is  Insane  and  Defective,  while  Map  IV  shows  the  pro- 
portion that  is  Feebleminded  or  Epileptic.  (The  detailed  figures  for 
each  county  are  given  in  Table  39.)  It  will  be  noticed  that  with  a  very 
few  exceptions,  it  is  the  older  lower  central  counties  that  have  the  high- 


COUNTV    ES. 

Cast*:    5,6.7.8,9.10,12. 


l-SR 


bCoI     bCoI. 
5RS.     dCal. 


CHART  9. 

This  chart  shows  a  fraternity  of  twelve  children,  nine  of  whom  were  feebleminded  and 
six  of  whom  are  in  the  County  Infirmary  at  present  (5,  6,  7,  8,  9,  10)  and  three  of  whom 
died  in  the  County  Infirmary.  One  of  the  brothers  who  died  in  the  County  Infirmary  had 
a  child  born  there  by  one  of  the  feebleminded  inmates  interviewed  (12).  This  same  inmate 
also  had  another  child  born  at  the  County  Infirmary  by  her  cousin  who  was  sent  to  the 
Ionia  Reformatory.  The  youngest  sister  of  this  fraternity  (5)  also  had  had  an  illegitimate 
son  born  at  the  County  Infirmary  and  sent  to  the  State  Public  School.  (For  explanation  of 
the  symbols  used  in  the  above  chart  see  first  chart  in  Appendix.) 

est  proportion  of  insanity  and  defectiveness.  Chart  9  shows  the  con- 
tribution of  a  single  family  to  the  feebleminded  population  of  one  of 
these  counties.  By  comparing  these  maps  with  Map  V  showing  the 
total  of  all  foreign  born  in  the  County  Infirmaries,  it  can  be  seen  that 
in  but  three  cases  (Montmorency,  Benzie  and  Gladwin)  have  any  of 
the  more  recently  settled  counties  both  a  large  foreign  population  and 
also  a  large  proportion  of  insane  and  defective. 


The  Insane  in  County  Infirmaries. 

Table  40  gives  the  data  concerning  the  different    forms    of   insanity 
found  in  the  County  Infirmaries.     Over  half   (56%)   of  the  407  cases 


67 

of  insanity  were  senile  dementia,  or  the  insanity  of  old  age.  Correspond- 
ing with  this  fact,  it  is  seen  in  Diagram  XV  that  the  ages  of  the  insane 
range  higher  than  do  those  of  any  other  group.     (See  page  74.) 

These  cases  of  old  age  insanity  present  a  number  of  different  prob- 
lems. Many  of  these  individuals  are  only  slightly  disoriented  or  have 
nothing  more  than  a  very  marked  memory  defect.  Such  cases  are  not  par- 
ticularly troublesome  as  inmates  of  the  County  Infirmary  nor  do  they  re- 
quire any  special  care.  Most  senile  dementia  cases  with  only  this  slight 
degree  of  dementia  are  probably  much  happier  living  in  the  infirmaries 
of  their  own  counties  than  they  would  be  in  the  State  Hospitals  for  the 
Insane.  There  are,  however,  other  cases  of  senile  dementia  who  have 
marked  delusions,  and  are  restless  and  irritable  to  such  an  extent  as  to 
make  it  necessary  that  they  have  constant  attention.  They  cannot  re- 
ceive this  care  and  attention  in  the  ordinary  County  Infirmary,  and 
should,  where  possible,  be  transferred  to  a  State  Hospital.  The  State 
Hospitals,  however,  are  frequently  too  overcrowded  to  accept  any  cases 
except  those  who  show  hope  of  recovery  or  are  a  menace  to  the  com- 
munity. 

The  majority  of  the  cases  of  the  other  forms  of  insanity  found  in 
the  County  Infirmaries  are  such  as  should  most  certainly  be  in  some 
regular  Hospital  for  the  Insane.  The  manic  depressive  cases,  at  least 
during  the  periods  of  insanity,  the  paranoid  cases,  and  those  dementia 
praecox  cases  that  require  constant  watching  should  all  receive  treat- 
ment at  an  Insane  Hospital. 


Before  going  into  a  detailed  discussion  of  the  Feebleminded  as  County 
Infirmary  problems,  it  seems  best  to  take  up  the  more  general  discus- 
sion of  such  facts  as  age,  nativity,  education,  occupation,  habits,  physical 
condition,  civil  condition  and  sex  in  relation  to  the  mental  status  of  the 
different  groups,  or  of  the  total  infirmary  population,  or  both,  as  the 
facts  in  each  case  may  seem  to  warrant. 

Nativity. 

The  proportion  of  foreign  and  of  native  born  in  the  County  Infirmaries 
of  the  state  is  of  interest  both  in  its  relation  to  dependency  and  in  its 
relation  to  insanity  and  defectiveness.  Forty-three  per  cent  of  the  total 
infirmary  population  was  foreign  born,  whife  53  per  cent  was  native 
born.  However,  it  is  only  by  considering  the  number  of  foreign  and 
native  born  in  the  infirmaries  in  relation  to  the  total  number- of  each 
in  the  total  population  of  the  state  that  one  can  determine  which  i» 
contributing  more  largely  to  the  dependent  class.  The  facts  are  striking. 
For  every  ten  thousand  foreign  born  in  the  State  of  Michigan  there  are 
24  foreign  born  who  are  living  in  the  County  Infirmaries  of  the  state, 
while  for  every  ten  thousand  of  native  born  in  the  state,  there  are  only 
eight  native  born  resident  in  the  County  Infirmaries.  Considering 
nativity  in  relation  to  mental  status,  we  find  the  following  facts:  In 
the  Normal  Group  in  the  County  Infirmaries  are  found  15.75  foreign 
born  for  every  ten  thousand  foreign  born  in  the  state  and  four  native 
bom  for  every  ten  thousand  native  born  in  the  state.  On  this  same 
ratio  of  number  per  ten  thousand  there  are  2.8  foreign  born  and   .9 


68 

native  born  in  the  Insane  Group,  and  2.6  foreign  born  and  2.3  native 
born  in  the  Feebleminded  Group. 

Briefly  stated,  the  foreign  born  portion  of  the  state's  population  is 
contributing  three  times  as  many  of  its  members  to  the  County  In- 
firmaries as  is  the  native  born  portion.  The  foreign  born  are  contribut- 
ing four  times  as  many  of  their  members  to  the  Normal  Group  in  the 
infirmaries  as  are  the  native  born,  while  their  contribution  to  the  In- 
sane Group  is  about  three  times  as  great  as  that  of  the  native  bom. 
But  the  foreign  born  and  the  native  born  contribute  about  equally  to 
the  Feebleminded  Group. 

Diagram  XIII  shows  the  contributions  of  the  different  countries,  both 
to  the  total  infirmary  population  and  to  each  different  group  in  that 
population.  Ireland  contributed  more,  87  per  10,000,  to  the  County  In- 
firmaries, than  did  any  other  country,  France  with  70.21  per  10,000  sec- 
ond, while  Scotland  with  57.1*7  per  10,000  came  third.  England  and 
Wales  together  contributed  35,  and  Germany  and  Prussia  28  per  10.000, 

By  glancing  at  this  Diagram  or  referring  to  Tables  41  and  42  it  will 
be  seen  that  all  of  these  countries  with  the  exception  of  England  and 
Wales,  contribute  a  relatively  larger  proportion  of  their  number  to  the 
Normal  than  to  the  Insane  and  Defective  Group.  This  is  especially 
true  of  Scotland,  which  contributed  over  four  times  as  many  to  the 
Normal  Group  as  it  did  to  the  Insane  and  Defective  Group.  The  coun- 
tries which  had  the  largest  proportion  of  their  number  in  the  Normal 
Group  were  Italy  and  Austria.  The  former  had  seven  times  and  the 
latter  over  six  times  as  many  of  its  members  in  the  Normal  as  in  the 
Insane  and  Defective  Group.  While  the  data  has  not  yet  been  tabu- 
lated in  such  a  w^av  as  to  show  the  alcoholic  habits  of  the  foreign  born 
or  those  of  the  different  nativities,  yet  the  investigators  felt  that,  at 
least,  in  the  case  of  those  bom  in  Ireland  and  Scotland,  the  excessive 
use  of  alcohol  was  one  of  the  chief  causes  of  their  dependency. 

Because  of  its  importance,  it  is  necessary  to  again  mention  the  fact 
that  the  foreign  born  portion  of  our  population,  despite  its  excessive 
contribution  to  the  dependent  class,  has  not  contributed  more  to  the 
Feebleminded  Group  in  the  infirmaries  than  has  the  remainder  of  the 
population.  (See  Diagram  XIV.)  As  a  matter  of  fact,  most  of  the 
Feebleminded  that  we  are  supporting  in  our  County  Infirmaries  are  native 
born.  The  comparison  of  the  foreign  bom  of  the  Normal,  Feebleminded, 
and  the  total  Insane  and  Defective  is  shown  by  Maps  VI,  VII  and  VIII, 
Four  hundred  ninety-five,  or  70  per  cent,  of  the  710  individuals  in  the 
Feebleminded  Group  were  born  in  the  United  States,  Not  only  is  this 
true,  but  only  38  per  cent  of  these  710  individuals  were  even  of  foreign 
or  mixed  parentage.  (See  Table  43.)  This  means  that  we  cannot  shift 
to  other  countries  the  responsibility  for  the  breeding  of  our  defective 
class.  We,  as  a  state,  cannot  even  shift  much  of  the  responsibility  upon 
other  states,  for  of  the  405  native  born  Feebleminded  in  the  infirmaries, 
324,  or  65  per  cent,  were  born  in  this  state.  Further  than  that,  of  this 
324  there  were  196,  or  60  per  cent,  who  were  born  in  the  county  which 
is  now  supporting  them  at  public  expense. 

Of  all  the  Feebleminded  in  the  County  Infirmaries,  nearly  one-half 
(45%)  were  born  in  Michigan.  The  state  is  breeding — we  might  al- 
most say  each  county  is  breeding — its  own  feebleminded.     (See  Table 


69 


DIAGRAM  Xm. 


No.perlQ00O  that  the  Foreign-Born  Co{//?/y 
Inf/rmary  /nmate^  are  of  The  Foreign- Born 
of  Fi/ch/gan. 


^SCOTLfJND 


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♦  NORMAL 
^SrOT/fL  INFlPrVIRY  F>OR 


0  /0  20J040S0S0  7060S0/000  10  2030405060706090/00 


70 


DIAGRAM  XIV. 


RATIO  OF  FOREIGN  TO  Nf^TIVE 
BORN  IN  COUNTY  INFIRMARIES,  WITH 
DISTRIBUTION  OF  NATIVE  BORN. 


HLL  INNlflTES 
Nomendaiure :  Foreign  born  ^K/k    Nafive  Born 

CLflSSES  OF  iNMflTE5 
NORMFIL 


DISTRIBUTION 
10        30        30        *0 


IN 
SO 


Unknouim    i         i 

PERCENT 

60      70      io        90      too 


state.  Born  I 

DISTRIBUTION      IN 

10      zo     SO     -Ao     so 


/N5F1NE 

Feebleminded 
Insane  flNO  Defective 
Total  Infirmfiry  Populhtion 

NATIVE  BORN 

Nomenclature:  Born  outside  of  Stafe 
CLF15SE6  OF  /NMFTTES  o 

Normal 
Insane 

Feebleminded 
Insane  And  Defective 
Total  Infirmary  Population 

3TRTE  BORN 

Nomenclature:  Born  outside  of  County  ^S^  County BomWi 
classes  of  inmates  DISTRIBUTION      IN 

Normal 
Insane 

Feebleminded 
Insane  And  Defective 
Total  Infirmary  Population 


■  Unknown  IH 

PERCENT 

60        70       eO       30 


100 


■  Unknownl. 

PERCENT 

eO         70         QO        90        lop 


71 

42.)     Some  of  the  ways  in  which  the  state  is  encumbering  itself  with 
this  burden  will  be  shown  in  a  later  section  of  this  report. 

In  regard  to  the  state  of  birth  of  the  native  born  population,  there 
is  a  noticeable  difference  in  the  County  Infirmary  population  and  in 
the  general  population  of  the  state.  This  difference  is  probably  due  to 
the  fact  that  such  a  large  proportion  of  the  infirmary  population  is  old. 

MAP  vr. 


DOMINION    OF    CANADA 


I  LLI  N  0   IS 


•  n  I  e  ««• 


,».       erib[ 


According  to  the  last  census  figures  79.6  per  cent  of  the  native  born 
living  in  Michigan  were  also  born  in  the  state.  Of  the  native  bom  in 
the  County  Infirmaries  only  46.9  per  cent  were  born  in  Michigan.  The 
census  gives  5.3  per  cent  of  Michigan's  native  born  as  born  in  New 
York,  3.6  per  cent  in  Ohio,  1.3  per  cent  in  Pennsylvania,  and  2.1  per 


72 

cent  in. Indiana.  Of  the  native  born  in  the  County  Infirmaries  24.8  per 
cent  were  born  in  New  York,  9.4  per  cent  in  Ohio,  4.3  per  cent  in  Penn- 
S3lvania,  and  2.6  per  cent  in  Indiana.     (See  Table  41.) 

MAP  VII. 


DOMINION     OF    CANADA 


I  L  LI  N  0   IS 


Age. 

The  age  of  the  inmates  of  the  County  Infirmaries  is  much  higher  than 
is  that  of  the  total  population  of  Michigan.  (See  Table  44.)  About 
17  per  cent  of  the  state's  population  is  from  45  to  64  years  old  as  con- 
trasted with  34  per  cent  of  the  County  Infirmary  population  and  only 
about  six  per  cent  are  65  years  or  over,  as  contrasted  with  48  per  cent 
of  the  County  Infirmary  population. 


73 

This  is,  of  course,  as  would  be  expected.  But  we  cannot  dismiss  the 
fact  simply  because  it  was  anticipated.  The  age  of  the  component  parts 
of  the  Infirmary  population  holds  more  interest  than  do  the  ages  of 

MAPVm 


\V,   DOIMINION     OF    CANADA 


the  total  population.  By  referring  to  Diagram  XV  it  will  be  seen  that 
the  marked  preponderance  of  the  higher  ages  in  the  infirmary  population 
was  largely  due  to  the  presence  of  the  Insane  Group.  In  the  discussion 
of  the  insane  in  the  infirmaries,  it  was  seen  that  senile  dementia 
was  the  form  most  frequently  found.  Of  all  the  insane  in  the  infirmaries 
70  per  cent  were  65  or  over. 

The  Feebleminded  Group  had  a  greater  proportion  of  young  individuals 


74 


DIAGRAM  XV. 


DISTRIBUTION  OF  fIGES  OF 
COUNTY  INFIRMARY  INMRTES  RCCORDING 
TO  SEX  HND  MENTAL   ST/^TUS. 

ToTRL  County  Infirmaqv  Popul/rt/on 


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75 

than  did  any  other  Group.  Only  22  per  cent  of  the  Feebleminded  were 
G5  or  over.  Of  the  Feebleminded  women  there  were  137,  or  nearly  42 
per  cent,  who  were  of  child-bearing  age  (15  to  45).  This  is  the  most 
important  fact  yielded  by  the  age  statistics. 

The  one  other  age  fact  that  deserves  special  comment  is  that  relating 
to  the  number  of  children  in  the  infirmaries.  There  were  in  all,  but 
46  individuals  who  were  less  than  15  years  old.  Of  these,  about  one- 
half  (25)  were  between  the  ages  of  5  and  15.  It  must  be  remembered 
that  in  some  of  the  counties,  the  County  Infirmaries  are  the  only  de- 
tention homes  for  the  temporary  care  of  dependent  children.  However, 
jt  is  an  exceedingly  undesirable  environment  for  a  child  and  it  is  felt 
this  use  of  the  County  Infirmary  should  be  minimized  as  much  as  pos- 
sible. But  besides  caring  for  this  class  of  children,  it  also  has  children 
who  are  not  detention  cases  but  are  permanent  County  Infirmary  resi 
dents.  These  cases  should  certainly  be  disposed  of  in  another  way,  either 
by  sending  the  child  to  the  State  Public  School  or  some  other  institu 
tion  appropriate  to  its  needs.  In  Chart  22,  Page  94,  is  shown  the  case 
of  a  girl  who  has  always  lived  at  the  County  Infirmary  and  should 
long  since  have  been  transferred  to  an  institution  for  the  feebleminded. 

Education. 

In  considering  the  education  of  the  County  Infinnary  inmates  the  fact 
of  the  very  large  proportion  of  old  individuals  and  those  of  foreign  birth 
must  be  borne  in  mind.  Remembering  these  facts,  it  is  surprising  to 
find  that  76  per  cent  of  the  Normal  Group  had  been  to  school,  while 
even  of  the  older  Insane  Group  there  were  53  per  cent  who  had  been. 
There  were  32,  or  nearly  two  per  cent,  of  the  Normals  who  had  been 
to  college,  while  143,  or  eight  per  cent,  had  been  to  high  school.  Of 
the  1,312  individuals  in  the  Insane  and  Defective  Group  only  two  per 
cent  had  been  to  college  and  only  23  (about  2%)  had  been  to  high  school. 
(See  Table  45.) 

Despite  the  fact  that  the  numbers  who  had  had  some  school  training 
were  relatively  large,  the  proportion  of  illiteracy  in  the  County  Infirm- 
ary population  was  much  larger  than  in  the  total  population  of  the 
state.  According  to  the  last  United  States  census,  3.3  per  cent  of  the 
population  of  Michigan  were  illiterate.*  Of  the  total  County  Infirmai'y 
population,  there  were  45.4  per  cent  who  were  illiterate.  This  percent- 
age of  illiteracy  is  unduly  high  as  it  includes  the  data  concerning  the 
Feebleminded,  who  would,  of  course,  be  very  largely  illiterate  (71.2%). 
But  the  percentage  of  illiteracy  in  the  Insane  is  higher  (84.5%),  while 
even  29.4  per  cent  of  the  Normal  Group  are  illiterate. 

As  indicated  before,  the  fact  that  the  foreign  born  make  up  a  slight- 
ly larger  portion  of  the  infirmary  population  than  do  the  native  born, 
would  lead  us  to  expect  a  slightly  higher  percentage  of  illiteracy  in 
the  County  Infirmary  population,  as  the  illiteracy  among  the  foreign 
born  white  in  Michigan  is  nearly  nine  times  as  great  as  it  is  among  the 
native  white  (9.3%  and  1.1%).  But  this  fact,  together  with  the  other 
fact  that  there  is  a  greater  percentage  of  illiteracy  in  the  older  element 
of  the  population  probably  does  not  account  entirely  for  the  fact  that 

♦Unable  to  write.  These  figures  refer  to  all  over  10  years  of  age.  Only  .3  of  one  per 
cent  of  the  County  Infirmary  population  was  below  10,  so  need  not  be  considered  separately. 


76 

there  is  a  higher  percentage  of  illiteracy  in  the  County  Infirmary  pop- 
ulation than  in  the  total  population  of  the  state. 

We  may  conclude,  therefore,  that,  on  the  whole,  the  dependent  class 
found  in  our  County  Infirmaries  are  less  literate  than  are  the  mass  of 
our  population. 

Occupation. 

In  harmony  with  the  facts  concerning  the  illiteracy  of  the  people  in 
the  infirmaries  are  the  facts  relating  to  the  occupations  of  the  men. 
There  were  17  per  cent  of  all  the  men  in  the  infirmaries.  44  per  cent 
of  the  eS82  Feebleminded  men  and  only  eight  per  cent  of  the  1,698  Nor- 
mal men,  who  had  either  had  no  occupation  or  whose  occupation  was 
unknown.  There  were  only  about  one-fourth  (28.7%)  of  the  Normal 
Group  men  who  had  a  trade,  as  contrasted  with  19.3  per  cent  of  the 
Insane  and  6.3  per  cent  of  the  Feebleminded.  Of  the  Normals  there 
were  .7  of  a  per  cent  and  of  the  Insane  1.6  per  cent  who  were  profes- 
sional men.  And  there  were  only  2.2  per  cent  of  the  Normals  and  2.4 
per  cent  of  the  Insane  whose  occupation  fell  in  the  commercial  class, 
such  as  merchant,  stenographer,  etcetera.     (See  Table  46.) 

Thus  it  will  be  seen  that  a  very  small  proportion  either  of  the  Normal 
or  those  who  had  once  been  Normal  had  had  an  occupation  requiring 
any  degree  of  skill. 

Habits — Institutional  History. 

There  was  such  a  large  proportion  (72%)  of  all  the  men  in  the  Coun- 
ty Infirmaries  who  had  drunk  that  one  cannot  but  feel  that  this  habit 
was  at  least  a  contributing  factor  in  their  dependence.  This  seems 
especially  true  in  considering  the  fact  that  37  per  cent  were  excessive 
drinkers.  Over  eight  per  cent  were  non-drinkers,  while  no  data  was 
obtained  concerning  12  per  cent.  A  larger  per  cent  of  the  Normals 
(45%)  than  of  either  the  Insane  (21%)  or  of  the  Feebleminded  (18%) 
drank  to  excess.     (See  Table  47.) 

Since  there  is  such  a  large  per  cent  (84%)  of  the  Normal  Group 
men  who  drank,  it  is  Avorth  while  indicating  the  extent  to  which  they 
drank.  There  were  12  per  cent  of  the  1,698  men  in  the  Normal  Group 
who  drank,  but  the  extent  was  unknown ;  13  per  cent  drank  occasionally 
in  moderation  ;  14  per  cent  drank  steadily  in  moderation ;  nine  per  cent 
drank  occasionally  to  excess;  eight  per  cent  steadily  in  moderation,  but 
with  an  occasional  excess;  18  per  cent  steadily  to  excess;  10  per  cent 
periodically  to  excess. 

Of  all  the  men  interviewed  there  were  11  who  were  at  the  time  suffer- 
ing from  delirium  tremens,  while  there  were  25  others  who  had  pre- 
viously had  them.  Of  the  36  cases  who  had  or  had  had  delirium  tremens, 
33  were  in  the  Normal  Group. 

Of  all  the  women  in  the  County  Infirmaries,  there  were  only  27  indi 
viduals  who  had  drunk.    Of  these  27,  eight  had  drunk  excessively. 

As  far  as  could  be  ascertained  there  were  only  41  individuals,  29 
men  and  12  women,  who  were  addicted  to  the  use  of  drugs.  Eight 
other  individuals  had  formerly  had  drug  habits. 

The  number  of  arrests  and  the  data  relative  to  institutional  residences 
probably  is  more  or  less  closely  connected  with  the  habits  of  the  indi- 
viduals concerned.     There  were  only  small  percentages  of  the  women 


77 

who  had  been  either  arrested  or  in  Correctionary  Institutions.  Twenty- 
five  per  cent  of  all  the  men  in  the  Infirmaries  had  been  arrested  from 
one  to  three  times,  four  per  cent  from  four  to  10  times  and  2.5  per  cent 
more  than  10  times.  There  were  27  men  who  had  been  in  the  House  of 
Correction  and  25  who  had  been  in  State  Prisons.    (See  Table  48.) 

The  per  cents  for  the  Normal  men  were  approximately  the  same  as 
for  the  total  number  of  men.  The  per  cents  for  the  Feebleminded  men 
were,  on  the  other  hand,  considerably  lower,  only  10  per  cent  having 
been  arrested  from  one  to  three  times;  two  per  cent  from  four  to  10 
times  and  five  per  cent  over  ten  times. 

While,  as  just  shown,  there  was  a  smaller  proportion  of  the  Feeble- 
minded than  of  the  Normals  who  had  been  arrested,  yet  when  it  comes 
to  the  proportion  who  had  been  in  other  institutions,  the  Feebleminded 
exceed  the  Normal.  Of  the  Feebleminded  l.G  per  cent  as  opposed  to 
.4  per  cent  of  the  Normal  Group  had  been  in  Hospitals  for  the  Insane 
(there  were  0.3  per  cent  of  the  Insane  who  had  been  in  Hospitals  for 
the  Insane)  ;  1.8  per  cent  of  the  Feebleminded  and  .7  per  cent  of  the 
Normal  had  been  in  State  Charitable  Institutions;  2.3  per  cent  Feeble 
minded,  1.2  per  cent  Normal  in  Private  Charitable;  7.2  per  cent  Feeble- 
minded, 3.9  per  cent  Normal  in  other  County  Infinnaries  in  Michigan ; 
1.3  per  cent  Feebleminded  and  .9  per  cent  Narmal  in  County  Infirmaries  in 
other  states.  The  Normal  individuals  had  been  at  the  same  County  Infirm- 
ary in  which  they  were  at  the  time  of  the  interview,  more  frequently  than 
had  the  Feebleminded  individuals.  Seven  hundred  eighty-seven  of  the 
Normals  had  been  in  the  County  Infirmary  previously,  with  an  average 
of  four  admissions.  Two  hundred  twenty-six  of  the  Feebleminded  had 
been  in  previously  with  an  average  of  2.6  admissions.  For  distribution 
of  previous  admissions  among  the  groups  of  different  mental  status  see 
Diagram  XVI.  This  fact,  however,  does  not  imply  that  the  Normals 
were  more  dependent  but  rather  the  opposite.  The  total  average  dura- 
tion of  residences  of  each  individual  in  the  Feebleminded  Group  was 
485  weeks,  while  that  of  each  individual  in  the  Normal  Group  was  only 
167  weeks.  To  sum  up — the  Feebleminded  are  less  excessive  drinkers 
than  the  Normals  and  possibly  correlative  with  this  is  the  fact  that 
there  are  fewer  of  them  who  have  been  arrested.  However,  they  are  a 
more  permanently  dependent  and  institutional  class  than  are  the  Nor- 
mals. 

Physical  Facts. 

Before  discussing  the  physical  condition  (see  Table  49)  of  the  indi- 
.viduals  in  the  County  Infirmaries,  attention  must  be  called  to  the  fact 
that  this  data  was  obtained  by  non-medical  investigators.  These  in- 
vestigators were,  however,  familiar  with  the  clinical  symptoms  of  cer- 
tain diseases,  especially  those  affecting  the  nervous  system.  Due  to 
these  facts,  some  parts  of  the  data  discussed  here  and  presented  in  the 
Appendix  are  of  more  value  than  other  parts.  It  is  felt  that  data  relat- 
ing to  the  different  forms  of  paralysis,  including  paralysis  agitans,  con- 
ditions of  the  eye,  injuries  and  other  evident  facts,  is  comparatively 
accurate.  An  attempt  was  made  to  verify  the  investigators'  conclusions 
by  information  from  the  Infirmary  Keeper  and  often  the  County  Physi- 
cian. This  was  particularly  true  of  venereal  infection.  In  diagnosing 
tabes  dorsalis,  the  accepted  clinical  tests  were  used  and  in  most  cases 


78 


DIAGRAM  XVI. 


PRE\//OU^  /7Dn/SyS/0/VsS  OF  COUNTY 
/NF/Rri/7Ry  /NM/rr£3  /fCCORD^NG  TO 
MENT/iL      SST/ITU6 


Normal  Group 


I- 


Irhsane 


6  fO  k5  » 

Times  /Jdmiffed 

Feebleminded 


10 


i 

~ 

— 

H 

- 

3 

d 

/ 

J 

^ 

fO 

13 

20 

c  /o 

I 


—  ---- 


J  10  IJ 

Time's  fJdmiff&<J 


20 


T/rnc>s  fldmi't-  fe  d 

Tota/  /n^ane'¥-Defect/tcGroup  Total  County  /nf/rmary  Fbp 


- 

if\ 

lO 

-J 

__ 

/^ 

■yd^ 

> 

■ntttt 

i 

9d 

t^ 

_ 

^  ,0 

p/^ 

„t       _.    + 

(f       

"  — —  _ 

°  f          >S            10            IS       .    20 

Times  /Idmiffed 


79 

a  history  of  the  case  was  obtained,  so  that  on  the  whole,  although  it  is 
realized  that  these  facts  are  of  limited  value,  they  would  seem  to  sug- 
gest the  physical  conditions  which  have  a  bearing  on  dependency. 

There  was  1.7  per  cent  of  3,334  people  in  the  County  Infirmaries  who 
had  an  active  syphilitic  infection,  while  .4  per  cent  more  had  gonorrhea. 
While  this  is  a  relatively  small  percentage  of  the  entire  number  of  in- 
mates, yet  it  is  large  enough  to  deserve  consideration.  In  the  majority 
of  cases,  the  individual  was  resident  at  the  County  Infirmary  at  least 
partly  because  of  this  disease,  yet  in  only  one  of  the  infirmaries  was 
there  a  special  detention  room  for  such  cases  and  even  there  the 
provision  for  the  segregation  of  these  cases  was  entirely  inadequate.  This 
means  that  the  infirmaries  are  attempting  to  take  care  of  a  dangerous 
infectious  disease,  without  any  special  means  either  for  caring  for  the 
patient  or  for  protecting  the  other  inmates.  In  one  of  the  counties,  the 
case  of  a  man  with  a  very  bad  active  syphilitic  infection  was  detailed  to 
the  care  of  a  feebleminded  woman  who  contracted  the  disease  through 
lack  of  antiseptic  precautions.  There  was  a  total  of  402  cases  or  12.1 
per  cent  of  the  total  number  of  inmates  who  either  had  or  had  had  a 
venereal  infection.  There  were  66  clear  cases  of  locomotor  ataxia  and 
15  more  questionable  cases  (altogether  2.4%  of  the  inmates).  As  another 
probable  evidence  of  syphilitic  infection  may  be  mentioned  23  cases  of 
nasal  necrosis. 

The  two  afflictions  most  frequently  found  were  paralysis  and  rheuma- 
tism. There  were  44  individuals  who  were  suffering  from  paralysis  agi- 
tans ;  761  or  22.8  per  cent  of  the  3,334  individuals  had  rheumatism.  The 
term  rheumatism  is  used  indiscriminately,  no  doubt,  by  the  inmates 
themselves  and  by  the  ones  in  charge  to  describe  pains  due  to  the  vari- 
ous other  causes.  However,  this  number  seems  sufficiently  large  to  indi- 
cate that  rheumatism  is  a  factor,  at  least,  in  the  County  Infirmary  prob- 
lem. 

There  were  a  large  number  of  the  County  Infirmary  inmates  who  were 
more  or  less  handicapped  by  injuries.  There  were  106  cases  (3.2%)  of 
all  the  individuals,  who  were,  at  the  time  interviewed,  suffering  from  a 
temporary  injury;  there  were  also  364  individuals  (10.9%)  who  had 
been  permanently  injured. 

As  perhaps  would  be  expected  in  a  population  made  up  so  largely 
of  older  people,  there  were  a  considerable  number,  6.6  per  cent  (222 
cases),  who  had  poor  eyesight.  There  were,  moreover,  3.4  per  cent  (115 
cases)  who  were  blind  in  one  eye,  while  3.2  per  cent  (107  cases)  were 
totally  blind,  and  383  or  11.5  per  cent  of  all  the  cases  were  deaf. 

There  were  84  individuals  who  were  tubercular.  There  were  13  cases 
of  chorea.  Chart  14  shows  something  of  its  inheritance  and  the  part 
which  it  sometimes  plays  in  dependency. 

The  most  important  of  the  other  physical  conditions  found  among  the 
inmates  were  seven  cases  of  pregnancy,  24  of  thyroid  enlargement,  70 
of  spinal  curvature  and  27  probable  cancerous  cases. 

The  thing  which  stands  out  most  prominently  in  a  comparison  of  the 
data  relating  to  the  physical  condition  of  the  groups  of  different  mental 
status  is  that  the  Normal  Group  was  considerably  more  physically  inca- 
pacitated than  was  the  Insane  and  Defective  Group.  This  fact  evidences 
itself  in  nearly  all  forms  of  physical  ailments  as  for  instance,  16.2  per 


80 

cent  of  the  Noraaal  Group  showed  a  venereal  history  as  opposed  to  6.1 
per  cent  of  the  Insane  and  Defective  Group. 

On  the  whole,  evidence  seems  to  point  to  physical  disability  being  a 
very  tangible  factor  in  dependency.  However  difficult  it  is  to  estimate 
its  exact  extent,  these  physical  factors  were  found  to  be  more  prevalent 
in  the  Normal  Group  than  in  the  Insane  and  Feebleminded  Group. 


County  53. 
Cose  1 5. 


o 


OtO 


6^ 


@ 


o 


^^ 


dCoI. 


Col. 


CHART  14.. 

This  chart  illustrates  roughly  the  inheritance  of  chorea  in  one  family.  The  patient  (13) 
in  the  County  Infirmary  had  a  father  who  died  suffering  with  this  disease,  and  also  a  son 
who  was  at  one  time  an  inmate  of  the  County  Infirmary.  Further,  his  sister's  son  died  at 
the  County  Infirmary  with  chorea  and  a  brother's  daughter  had  the  same  disease.  (For 
explanation  of  the  symbols  used  in  the  above  chart  see  first  chart  in  Appendix.) 

Civil  Condition. 

In  taking  up  the  civil  condition  of  the  County  Infirmary  inmates  we 
find  a  number  of  facts  which  are  striking.  (See  Table  50.)  Of  the 
total  men,  there  were  only  13.8  per  cent  and  of  the  total  women  only 
14  per  cent  who  were  married  at  the  time  interviewed.  Contrast  this 
with  the  1910  census  figures  which  give  58.3  per  cent  of  the  men  and 
62.2  per  cent  of  the  women  of  the  state  as  married.  There  are  45.8 
per  cent  of  the  men  and  34.2  per  cent  of  the  women  in  the  County  In- 
firmaries who  have  never  married,  while  in  the  state  there  were  only 

36.1  per  cent  of  the  men  and  27.1  per  cent  of  the  women  who  were  single. 
Because  of  the  more  advanced  age  of  the  infirmary  inmates  these  figures 
do  not  give  the  real  difference  which  exists  in  the  marital  condition  of 
the  County  Infirmary  population  and  the  total  population  of  the  state. 
Over  nine-tenths  (92%)  of  the  men  in  the  County  Infirmaries  are  over 
34  years  of  age  and  of  the  total  state  male  population  of  this  age  only 

10.2  per  cent  had  never  married,  and  80  per  cent  were  married  at  the 


81 

time  of  the  census.  Nearly  nine-tenths  (^6%)  of  the  women  in  the 
County  Infirmaries  were  over  34  years  of  age.  For  those  in  the  state 
population  who  were  over  this  age.  the  census  gives  only  0.4  per  cent 
single  and  73.7  per  cent  as  married.  We  see,  then,  that  a  very  much 
greater  percentage  of  all  the  County  Infirmary  population  than  of  the 
general  population  have  never  married,  and  that  a  very  much  smaller 
jjercentage  was  married  at  the  time  they  were  interviewed. 

Some  marked  diff'erences  are  found  to  exist  in  the  different  groups. 
Thus  the  percentage  of  normal  women  who  had  never  married  was  only 
13,  which  is  much  nearer  the  percentage  found  in  the  total  female 
population  of  the  state.  But  there  were  40  per  cent  of  the  normal  men 
who  had  never  married.  There  were  only  0.7  per  cent  of  the  feeble- 
minded women  Avho  were  married  at  the  time  intenMewed  and  there  were 
over  57  per  cent  who  had  never  married.  These  facts,  however,  are  some- 
what misleading,  for  there  were  30  per  cent  of  the  unmarried  feeble- 
minded women  who  had  given  birth  to  children.  There  were  75  per 
cent  of  the  feebleminded  men  who  had  never  marrie*!.  There  were  fewer 
who  had  always  remained  single  in  the  Insane  Group  than  in  any  other. 
Only  31.3  per  cent  of  the  insane  men  and  14.5  per  cent  of  the  insane 
women  had  never  married. 

Of  the  1,781  individuals  in  the  County  Infirmaries  who  had  teen  mar- 
ried, there  were  55  per  cent  who  had  been  widowed  one  or  more  times, 
18  per  cent  who  had  been  separated,  and  11  jjer  cent  who  had  been  divorc- 
ed. 

There  are  certain  other  facts  which  are  closely  related  to  the  civil  con- 
dition of  the  individuals  studied.  These  facts  will  be  briefly  stated  here. 
The  facts  in  regard  to  the  size  of  the  families  of  the  County  Infirmary 
inmates  are  contrary  to  the  generally  accepted  idea  that  the  defectives 
have  larger  families  than  have  the  normals,  (See  Tables  51  and  54.) 
There  were  152  individuals  in  the  Feebleminded  Group.  211  in  the  In- 
sane Group  and  905  in  the  Normal  Group  who  had  been  married  or  wlio 
had  had  illegitimate  children.  The  individuals  in  the  Feebleminded 
Group  had  had  an  average  of  only  2.8  children,  those  in  the  Insane 
Group  an  average  of  3.7,  while  those  in  the  Nornml  Group  had  had  the 
highest  average  of  all,  3.8  children.  There  were,  however,  fewer  of  the 
married  Feebleminded  (3.5%)  who  had  never  had  children  than  there 
were  of  either  the  Insane  (7.4%)  or  of  the  Normal  (9.4%).  But,  con- 
sidered again  from  the  standpoint  of  the  group  having  the  largest 
families,  we  find  that  there  were  17  per  cent  of  the  Normals  who  had  had 
more  than  four  children,  Avhile  of  the  Insane  there  were  17.2  per  cent 
.and  of  the  Feebleminded  only  0.8  per  cent  who  had  had  more  than  this 
number  of  children. 

This  comparison  shows  that,  at  least,  for  the  County  Infirmary  in- 
mates, the  Normal  and  the  Insane  both  have  larger  families  than  do  the 
Feebleminded.  We  cannot  say,  however,  that  this  invalidates  the  state- 
ment so  generally  made  that  the  feebleminded  are  reproducing  at  a 
higher  rate  than  are  the  normals.  It  must  be  remembered  that  we  are 
here  dealing  only  with  the  dependent  class.  It  is  the  poorer  class  that 
has  the  larger  number  of  offspring,  while  those  of  the  wealthier  class, 
the  lower  birth  rate.  This  would  tend  to  make  the  average  number  of 
children  born  to  normal  parents  much  lower  and,  on  the  other  hand,  it 
is  safe  to  assume  that  the  number  of  children  born  to  the  Feebleminde<l 

11 


82 

Avlio  have  been  for  a  considerable  period  in  the  County  Infii*maries  (the 
average  period  of  the  last  residence  was  8.4  years)  is  less  than  the  num- 
ber born  to  those  who  are  living  at  large. 

Of  the  married  and  those  who  had  illegitimate  children  there  were  in 
the  Feebleminded  Group  only  17.3  per  cent  who  have  children  still  liv- 
ing, while  in  the  Insane  Group  there  are  36.2  per  cent  and  in  the  Normal 
36.1  p^r  cent  who  still  have  living  children.  There  are  16.7  per  cent 
of  those  in  the  normal  group ;  14.3  per  cent  of  those  in  the  Insane  Grouj* 
and  6.1  per  cent  of  those  in  the  Feebleminded  Group  who  have  more 
than  two  children  living. 

There  are  71  unmarried  individuals  (of  whom  53  were  feebleminded 
women)  who  had  given  birth  to  121  children.  (See  Table  52.)  There 
were  20  married  women  (of  whom  10  were  feebleminded)  who  had  given 
birth  to  30  illegitimate  children,  making  a  total  of  91  women  having  had 
151  illegitimate  children.  Nineteen  of  the  inmates  in  the  Infirmaries  were 
of  illegitimate  birth.  Three  of  these  were  Normal,  nine  Feebleminded, 
(illustrated  by  chart  16),  one  Insane  and  six  of    Questionable    men- 


COUNXV  60. 
Caiit    61. 


W 


clCo.I.\ 


o 


d    SypV\ili& 


I       \ 
I  \ 

I 
I 


F? 


H. erf  Cor. 


CHART  16. 

This  chart  shows  the  back-ground  of  a  feeijleminded  man  (61).  His  mother,  a  prostitute 
who  died  at  the  County  Inflrmary,  cohabited  with  his  father,  her  own  feebleminded  nephew. 
His  father  liad  two  brothers  who  wei-e  feebleminded  and  on  his  mother's  side  there  was  a 
daughter  who  died  of  syphilis  and  a  feebleminded  grandson  who  had  been  in  the  House 
of  Correction.  (For  explanation  of  the  symbols  used  in  the  above  chart  see  first  chart  in 
Appendix.) 


tality.  Fourteen  of  the  individuals  now  in  the  County  Infirmaries 
had  been  born  there.  (See  Table  53.)  Of  these  only  one  was  Normal, 
nine  were  Feebleminded,  and  four  were  of  Questionable  mentality.  Fifty 
of  the  prei^ent  inmates  had  given  birth  to  children,  72  in  all,  in  the 
County  Infirmaries.     Forty-six  of  these  50  inmates  were  Feebleminded, 


83 

three  were  Normal  and  one  was  Insane.     Of  the  72  children,  68  were 
bom  of  feebleminded  mothers. 

There  seems  to  be  a  tendency  for  different  members  of  the  same  fami- 
lies to  be  in  the  County  Infirmaries.  There  were  at  the  time  of  the  in- 
vestigation 96  families  who  had  more  than  one  member  living  in  one 
of  the  County  Infirmaries.     (See  Table  55.)     Chart  11  shows  families 


County  4Z. 
Cpses:   3,11.12. 


Cousins  f 


(S)-- -T- 


d.Co.1. 


1 

I 

.  I 

I 


dCal. 


o 


\E 


^ 


CHART  II. 

In  the  first  generation  there  is  the  marriage  of  two  individuals  who  were  probably  cousins. 
Two  of  their  children  died  in  the  County  Infirmary,  one  of  whom  had  a  feebleminded  son 
(No.  11),  who  is  at  present  an  inmate  tliere.  Another  daughter  of  these  old  people  was 
feebleminded  and  had  an  illegitimate  daughter  who  in  turn  had  two  feebleminded  daughters 
by  her  first  marriage.  These  two  daughters,  (No.  12  and  3)  are  also  inmates  of  the  County 
Infirmary.  The  older  of  these  (No.  12)  is  married  to  her  second  cousin  (No.  11).  Of  this 
marriage,  there  is,  at  least,  one  probably  feebleminded  son.  (For  explanation  of  the  symbols 
used  in  the  above  chart  see  first  chart  in  Appendix.) 


illustrating  this.    These  96  families  contributed  altogether  219  members  to 
the  population  of  the  County  Infirmary. 

There  were  165  individuals  who  had,  either  at  the  time  of  the  investi- 
gation, or  liad  had  previously,  one  or  more  blood  relations  (280  in  all) 
in  the  infirmaries.  (See  charts  10  and  21.)  There  were  227  individuals 
vvh.0  had  either  blood  relations  or  relatives  by  marriage  (359  in  all) 
who  were  or  had  been  in  the  County  Infirmaries.  There  were  117  cases 
in  which  both  husband  and  wife  were  or  had  been  in  the  infirmary. 

There  were  a  number  of  the  relatives  of  the  infirmary  inmates  who 
had  been  in  other  institutions.  Twenty-four  of  the  relatives  of  these 
inmates  had  been  in  other  County  Infirmaries;  76  had  been  in  the  State 
Public  School;  27  had  been  in  the  Lapeer  Home  and  Training  School; 
75  had  been  in  Hospitals  for  the  Insane;  20  had  been  in  State  Prisons. 
Facts  were  learned  about  the  mental  condition  of  a  part  of  the  relatives 
of  the  infirmary  inmates.     There  were  227  relatives  of  tliese  inmates 


84 

who  were  feebleminded  (see  chart  25),  46  who  were  epileptic;  127  who 
were  insane.     (See  Table  55  and  Charts  2,  8.) 

Sex. 

Diagram  XVII  shows,  that  in  proportion  to  the  numbei*s  of  each  sex 
in  the  total  population  of  Michigan,  there  are  nearly  three  times  as  many 
men  as  women  in  the  County  Infirmaries.  It  also  shows  that,  on  the 
same  basis,  there  are  over  five  times  as  many  men  of  Normal  ^Mentality 


County  38. 
Coses  18-19. 


Co.  I. 


Co.l. 


\9 


S  16 


0I.K5.H. 


Cal. 


Lansinq  SforB.      bCoI. 

^  dCoI. 


bCo.I. 


CHART  10. 

This  chart  shows  an  old  man  and  his  wife  (IS,  19)  who  were  Inmates  sonic  twenty  years 
ago  in  another  County  Infirmary  than  the  one  In  which  they  were  interviewed.  They  decided 
to  be  married  and  although  no  children  came  of  this  union,  they  united  two  strains  which 
are  worth  noting.  On  his  side,  his  mother  and  step-father  were  both  in  the  County  Infirm- 
ary. She.  on  the  other  hand,  had,  among  other  children,  an  Illegitimate  daughter  who  was 
feebleminded,  syphilitic  and  irresponsible  sexually.  This  daughter  had  at  least  two  con- 
sorts, one  to  whom  she  was  married  and  who  liad  been  in  the  County  Infirmary,  and  the  other 
who  is  the  father  of  at  least  three  of  her  Illegitimate  children.  Two  of  these  three  children 
were  born  at  the  County  Infirmary.  One  of  them,  feebleminded  and  sexually  Immoral  like 
her  mother,  has  given  birth  to  an  illegitimate  child  in  the  County  Infirmary.  The  strlliing 
thing  about  this  chart  is  that  here  wo  have  a  great-grandmother,  probably.  In  the  County  In- 
firmary, whose  illegitimate  feebleminde<l  daughter,  granddaughter  and  great-grandchild 
have  all  been  dependent  on  the  County.  (For  explanation  of  the  symbols  used  in  the  above 
chart   see   first   chart   in    Appendix.) 


in  the  County  Infirmaries  as  there  are  women  of  Normal  Mentality, 
while  the  proportion  of  the  two  sexes  in  the  Insane  and  Defective  Group 
is  very  nearly  equal.. 

The  question  of  chief  interest  in  relation  to  the  dependency  of  the 
sexes  is  this:  Why  should  we  find  that  for  every  normal  woman  in  our 
County  Infirmaries  there  are  nearly  six  normal  men?  The  interest  in 
this  question  is  increased  when  we  find  that,  on  the  whole,  the  normal 


85 

men  are  younger  than  the  normal  women,  and  ought,  therefore,  to  be 
more  capable  of  caring  for  themselves.  Of  the  normal  women  65.2  per 
cent  and  only  52.1  per  cent  of  the  normal  men  are  65  or  over,  while  12 
})er  cent  of  the  men  as  opposed  to  S.6  per  cent  of  the  women  are  less 
than  46  vears  old. 

The  only  Avay  to  answer  this  question  is  to  study  all  the  facts  which 
were  ascertained  in  regard  to  the  normal  men  and  women.  The  men  of 
the  Normal  Group  have  had  better  educational  advantages  than  have 
the  women.  While  abont  an  equal  proportion  of  the  two  sexes  have  been 
to  high  school  and  college^  yet  there  were  76  per  cent  of  the  men  as 


COUNTV     72.. 
Case.  I- 


^ 


© 


Co.I 


Col. 


Col. 


Col 


hCol. 


CHART  ai. 

This  woman  (1)  besides  having  a  feebleminded  sister,  has  had  four  children  all  of  whom 
have  been  In  the  County  Infirmary.  One  of  them,  probably  feebleminded,  had  an  illegitimate 
child  born  in  the  County  Infirmary,  who  in  turn  is  proving  herself  to  be  sexually  immoral. 
(For  explanation  of  the  symbols  used  in  the  above  chart  see  first  chart  in  Appendix.) 


opposed  to  70  per  cent  of  the  women  who  had  been  to  common  school. 
There  were  only  29  per  cent  of  the  normal  men  as  against  37  per  cent 
of  the  normal  women  who  were  illiterate.  Inferior  preparation  to  cope 
with  society  does  not  seem,  therefore,  to  have  caused  more  men  than 
women  to  have  become  dependent. 

Analyzing  the  data  relative  to  the  physical  condition  of  the  mentally 
normal  of  the  two  sexes,  we  find  some  facts  that  may  help,  at  least,  a 
little,  in  the  answering  of  our  question.  The  two  diseases,  (namely, 
paralysis  and  rheumatism)  which  we  have  already  seen  to  be  present  in 
the  largest  number  of  cases,  are  found  to  an  almost  equal  extent  in 
both  sexes.  About  the  same  proportion  of  women  as  of  men  are  found 
to  be  blind. 


8G 

There  were  more  of  the  meu  (17%)  than  of  the  women  (9.7%)  who 
were  either  temporarily  or  permanently  injured.  There  were  also  more 
men  (4.7%)  than  women  (.•i%)  who  were  tubercular. 

But  it  is  when  we  come  to  the  facts  relating  to  the  habits  of  the  two 
sexes  that  we  find  the  greatest  difference.  Thus  18  per  cent  of  the  men 
as  opposed  to  3.9  per  cent  of  the  women  had,  or  had  had  a  venereal 
disease  and  4.1  per  cent  of  the  men  and  only  1.4  per  cent  of  the  women 
were  suffering  from  locomotor  ataxia.  Of  the  normal  men  45  per  cent 
drank  excessively  while  of  the  normal  women  only  1.1  per  cent  drank 


County  77. 
Case  8. 


-T<5     i     ¥7 


1 


dCoI 


Col. 
d  Lopeer-  j 


CHART  £5. 

This  patient  (8)  although  at  present  a  County  Infirmary  resident,  is  committed  to  the 
Lapeer  Home  and  Training  School.  He  is  78  years  old  and  his  place,  it  would  seem,  could 
very  well  be  filled  to  better  advantage  in  the  State  Institution.  In  his  mother's  fraternity, 
there  were  four  feebleminded,  three  of  whom  had  been  at  the  County  Infirmary  and  one  of 
whom  had  died  at  the  Lapeer  Home  and  Training  School.  (For  explanation  of  the  symbols 
used  In  the  above  charts  see  first  chart  in  Appendix.) 


excessiveh'.    Only  one  per  cent  of  the  women  as  opposed  to  34.7  per  cent 
of  the  men  had  been  arrested. 

While  we  have  not  been  able  to  find  an  absolute  answer  to  our  ques- 
tion, yet  it  seems  safe  to  say  that  the  facts  at  our  disposal  indicate 
rather  clearly  that  the  most  probable  explanation  of  the  fact  that  there 
are  so  many  more  normal  men  than  women  in  our  County  Infirmaries 
lies  mainly  in  the  loose  living  of  the  men. 

Summary — Causes  of  Dependency, 

Dependency  implies  financial  impoverishment.  However,  it  is  the 
causes  of  this  impoverishment  in  which  Ave  are  interested.  Occasionally 
the  economic  factor,  for  instance,  as  in  the  case  of  accidental  loss  of 


87 

property,  seems  to  stand  as  the  dominant  cause,  and  in  this  sense  only 
can  it  be  said  to  be  a  fundamental  cause  of  dependency.  The  other 
causes  leading  to  impoverishment  seem  to  group  themselves  under  the 
general  heads  of  mental  condition,  physical  condition  and  habits.  Here 
again  it  is  seldom  that  we  find  but  a  single  factor;  more  often  it  is  a 
combination  of  factors.  The  relative  importance  of  these  factors  would 
be  difficult  to  determine  even  in  a  single  case.  Therefore,  it  was  im- 
possible to  form  any  conclusions  on  this  point  for  a  large  group  of 
cases.  All  that  can  be  done  is  to  indicate  the  possible  bearing  of  these 
factors   upon    impoverishment   and    therefore   upon    dependency.     It  is 


County  II 

Case  10. 


& 


S+a^e  Hos? 


eHa 


5 


\M 


K.&H.\ 


K 
IN 

I     \ 


r"        (Tei       i»)l 


(*'l 

^ 


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d.K.SH. 


K.S.H. 


W^  d'd'icg'Ei  ci'i'W'i'" 


/        Co. I.    Col. 
Lapeer 
H.*T5. 


CHART  Z. 

Here  Is  the  case  of  a  woman  (III,  80),  who  was  married  at  17  to  a  feebleminded  man 
(III,  29).  In  a  year  a  child  was  born  (IV,  61)  who  later  became  an  alcoholic,  at  least.  His 
mental  condition  is  unascertained.  Soon  after  his  birth,  his  mother  was  committed  to  the 
Kalamazoo  State  Hospital  for  a  year,  released,  gave  birth  to  a  second  child  (IV,  62)  whose 
mentality  is  unknown.  She  was  sent  to  the  hospital  again  for  a  year,  released  only  to  have 
three  feebleminded  children,  one  (63)  of  whom  is  the  patient  interviewed,  in  the  County 
Infirmary,  and  the  other  two  (66,  67)  have  been  at  the  County  Infirmary  and  are  now  at  the 
Lapeer  Home  and  Training  School.  She  also  had  three  miscarriages  and  two  children  died 
in  infancy.  She  was  finally  taken  back  to  the  Kalamazoo  Stat6  Hospital  and  died  there.  She 
has  a  sister  (83)  who  is  at  the  Kalamazoo  State  Hospital  now  and  another  sister  (81)  and 
brother  (77)  who  are  insane.  Both  her  mother  (41)  and  father  (21)  were  insane.  This 
family  has  cost  the  State  $15,000  through  its  members  in  institutions  in  the  state.  (For 
explanation  of  the  symbols  used  in  the  above  chart  see  first  chart  in  Appendix.) 

Note  :     Prom  facts  gathered  for  the  State  Board  of  Health  and  published  in  Public  Health, 
December,  1912,  with  some  revision. 


clear  that  in  at  least  39.3  per  cent  of  the  3,334  intirinary  cases,  either 
insanity,  feeblemindedness,  or  epilepsy,  were  the  causes,  and  probably 
the  dominant  causes,  of  the  dependency.  This  was  true  in  65.5  per  cent 
of  the  women  and  in  only  30  per  cent  of  the  men.  However,  any  other  fac- 
tor may  have  entered,  A  feebleminded  individual  may  have  had  parents, 
who,  though  themselves  feebleminded,  yet  were  capable  of  supporting 


88 

their  family.  Sickness,  accident  or  desertion  may  have  removed  the 
wage-earner,  and  consequently  the  family  became  County  Infirmary 
eharges.    Charts  17,  19  and  26  illustrate  this. 

Where  the  factor  of  mental  condition  does  not  enter,  the  facts  indi- 
cate that  diseases,  accidents,  together  with  excessive  alcoholism  and 
loose  sex  habits  are  the  most  important  causes  of  dei^endency. 

With  the  normal  women  the  factors  very  largely  reduce  themselves  to 
])liysical  condition,  combining  with  the  economic.  In  the  case  of  the 
normal  men,  all  the  above  mentioned  factors  enter. 

To  sum  up,   then,  the  causes  of  impoverishment   and  therefore,  de- 


COUNTY     24. 
Ca&es-Z6-32. 


(h)  i-6  €^  (^  (s>T    [iH^Tv 


dCo-I. 


dPSH. 


dLRSH. 


(£> 


m 


(b^ 


Lopeer 
H*T.S 


CHART  a. 

This  chart  shows  the  inter-relation  of  feeblemindedness  and  insanity  in  one  family  and  in 
their  connections  by  marriage. 

Case  No.  32 — An  old  insane  man  has  three  sisters  who  were  probably  insane,  and  two 
feebleminded  brothers,  one  of  whom  died  at  the  County  Infirmary.  This  same  brother's  wife's 
sister  (Case  2G)  is  an  inmate  of  the  County  Infirmary.  The  other  feebleminded  brother 
married  a  feebleminded  woman  whose  nephew  is  feebleminded  and  has  two  feebleminded 
daughters,  one  of  whom  is  at  the  I>apeer  Home  and  Training  School.  (For  explanation  of 
the  symbols  used   in   the  above  chart  see  first   chart  in   Appendix.) 

pendency,  reduce  themselves  to  the  economic,  mental,  and  physical  con- 
dition as  >vell  as  habits  of  the  individuals.  But  of  these,  the  mental 
condition,  especially  feeblemindedness,  was  a  factor  in  the  greatest  num- 
ber cases.  TV^e,  therefore,  turn  to  a  consideration  of  its  significance  in 
relation  to  dependency. 


The  Feebleminded    in  the    County  Infirmaries. 

Of  the  710  feebleminded  individuals  in  the  County  Infirmaries  39  were 
idiots.  Most  of  these  cases  were  unable  to  care  for  themselves,  the 
remaining  were  either  imbeciles  or  morons,  of  whom  it  was  definitely 
know  380  were  imbeciles  and  114  morons.    Many  of  the  iml>eciles  and  all 


89 


DIAGRAM  XVII. 


QjqTlO  PER  10,000  POPULATION 
or  M/JLE5  flND  FEMffLES  IN  COUNTY 
INFIPMflRIES, /ACCORDING   TO 
MENTHL   STPITUS. 


NoRM/iL  Group 


Ins/^ne  Rnd 
Defective  Group 


lOT^L  /nf/rm^ry 

POPULRTION 


MFILE 


FEMtRLE 


90 

the  morons  were  able  to  do  the  simpler  tasks  of  the  institution.  Of 
the  morons,  many  were  of  the  type  that  in  the  community  at  large  would 
simply  be  classed  as  ''not  bright,"  or  inefficient. 

In  considering  the  feebleminded  man,  the  morons  and  high  grade  im- 
beciles most  largelj^  represent  a  certain  tj^pe  of  unskilled  laborer,  just 
capable  of  getting  along  in  the  world,  provided  no  unusual  situation 
presents  itself.  Others  of  this  group  represent  the  vagrant  class.  Some- 
times the  same  individual  is  admitted  to  the  infirmary  several  times 
during  the  same  year,  but  more  frequently  he  uses  it  as  a  refuge  during 


COUNTV     61. 
Cases    14-15-16- 


r? 


i 


Cal. 


CHART  17. 

Here  the  four  feebleminded  children  (14,  15,  17,  18)  of  feebleminded  parents,  together  with 
their  mother  (16)  are  all  thrust  upon  the  County  Infirmary  for  care  when  the  wage-earner, 
their  father,  deserts  the  family.  The  girl  (15)  has  cohabited  with  her  brother  as  well  as 
another  County  Infirmary  inmate  and  the  entire  four  children  are  imbeciles,  able  to  do  very 
little  toward  their  own  support.  (For  explanation  of  the  symbols  used  in  the  above  chart 
see  first  chart  in  Appendix.) 


the  winter.  Sooner  or  later,  these  men  become  permanent  county 
charges.  The  following  case  from  the  infirmary  of  County  No.  77  illus- 
trates the  way  in  which  the  infirmaries  are  used  by  these  individuals,  a» 
well  as  the  general  vagrant  character  of  the  existence  which  they  lead. 
James  M.  was  61  years  old.  At  the  time  interviewed,  July  13,  1914, 
he  presented  a  well  developed  case  of  paralysis  agitans.  This  fact,  how- 
ever, does  not  prevent  his  continued  wanderings.  He  has  a  touch  of 
good-natured  Irish  wit,  but  the  mentality  of  a  boy  of  ten.  James 
has  ahvays  led  a  free  and  easy  existence,  roaming  from  place  to  place, 
drinking  excessively,  and  having  contracted  gonorrhea  "two  dozen 
times."  He  first  came  to  the  County  Infirmary  of  County  No.  77  in 
1807.  Since  that  time  he  has  l)een  there  six  different  times  for  short 
periods.    He  has  also  been  at  the  Wayne  County  Infirmary  seven  times 


9X 

and  at  the  Jackson  County  Infirmary  once.  He  has  served  at  least  60 
days  at  the  Detroit  House  of  Correction  and  also  two  years  for  lar- 
ceny at  the  Ionia  Reformatory. 

But  James  M.  has  never  been  satisfied  to  live  quietly  in  one  locality. 
During  the  period  of  years  in  which  he  has  been  visiting  the  Michigan 
institutions,  he  has  also  spent  a  part  of  his  time  in  New  York  State. 
The  records  of  the  Monroe  County  Almshouse  show  that  he  was  a  resi- 
dent twice.  The  records  of  the  Cheemung  County  Almshouse  show  that 
he  was  resident  there  in  1900.  These  records  also  state  that  he  is  feeble- 
minded.   In  1901  he  was  sentenced  to  the  Erie  County  Penitentiary  on 


County    67. 
Cases-8-9-10. 


& 


T.SH. 


TSM.    TS.H. 


'  ^  ^  4  ^°  6 

Col.      Cal.    Col.      f        /bCoT 


CHPiRT  19. 

Here  Is  an  Instance  where  the  removal  to  an  Insane  Hospital  of  the  wage-earner  because 
of  mental  derangement  has  resulted  In  his  feebleminded  wife  (8)  and  family  of  four  children 
all  becoming  county  charges.  A  fifth  child  (9)  was  born  to  her  In  the  County  Infirmary, 
but  the  father  of  this  child  Is  not  her  husband,  but  a  man  who  may  also  bring  the  taint  of 
insanity  to  the  offspring,  since  two  of  bis  fraternity  are  in  the  Traverse  City  State  Hospital. 
(For  explanation  of  the  symbols  used  in  the  above  chart  see  first  chart  In  Appendix.) 

a  vagrancy  charge.  The  following  letter  written  by  the  Superintendent 
of  the  Poor  of  Ontario  County,  New  York,  under  date  of  October  27, 
1914,  gives  evidence  of  his  vagrancy: 

"Know  nothing  of  him  except  that  he  comes  every  year  or  two  and 
stays  one  month  or  so  and  departs.  He  has  now  arrived  at  the  County 
Home,  I  suppose  from  Michigan,  and  will  probably  stay  until  the 
wanderlust  overtakes  him  again.  He  is  partially  paralyzed,  and  shuffles 
around  but  seems  to  be  able  to  go  anywhere  he  wants  to  go  on  free 
transportation."* 

♦For  New  York  data  we  are  indebted  to  Dr.  Gertrude  E.  Hall,  of  the  New  York  State 
Board  of  Charities,  the  Bureau  of  Analysis  and  Investigation. 


92 

James  also  claims  to  have  served  terms  in  penal  institutions  in  Wash- 
ington, D.  C,  in  Rochester  and  Buffalo,  N.  Y.,  in  Chicago  and  in  Jack- 
son State  Prison,  but  these  latter  facts  were  not  verified. 

The  moron  man  undoubtedly  has  a  bearing  on  the  problem  of  feeble- 
mindedness. However,  just  what  this  bearing  is,  just  how  much  he 
contributes  to  the  propagation  of  the  feebleminded  class,  is  not  clear. 
He  is  a  less  well  defined  type  than  is  the  moron  woman.  Her  relation 
to  the  problem  can  be  definitely  seen.  It  is  best  that  there  be  a  full 
realization  of  her  contribution  to  the  increasing  burden  of  defectiveness 


County  77. 

Case  35. 


.35 


F? 


Car. 
Lapeei' 

H*T.«) 


Co.1 
Lapeer 

H-TS. 


CO.1 


Col 


CHART  Z6. 

Although  the  union  of  these  two  feebleminded  parents  was  apparently  legalized  by  marriage, 
the  father  soon  deserted  the  family  and  left  the  mother  (35)  and  Ave  children  to  be  de- 
pendent on  the  County  Infirmary.  The  three  older  children  were  feebleminded  and  have 
found  their  way  to  the  Lapeer  Home  and  Training  School,  while  the  whereabouts  of  the 
other  two  are  unknown.  (For  explanation  of  the  symbols  used  in  the  above  chart  see  first 
chart  in   Appendix.) 


which  the  state  is  bearing,  together  with  a  sincere  attempt  to  cope  with 
the  situation  in  an  adequate  manner.  This*  is  the  only  immediate  and 
tangible  way  of  attacking  the  problem. 

It  is  our  intention  to  show  from  the  facts  obtained  concerning  the 
feebleminded  woman  at  the  County  Infirmaries  just  what  her  relation 
is  to  the  problem  of  feeblemindedness. 

This  relation  can  best  be  shown  by  a  study  of  typical  cases  from 
among  those  interviewed  at  the  infirmaries.  Chart  7  and  Chart  22 
give  good  pictures  of  the  high  grade  feebleminded  girl.  The  first  case 
shows  how  this  type  of  girl  is  a  menace  to  the  community  while  at  large 
and  the  second  illustrates  how  equally  much  of  a  menace  she  is  when 
confined  in  an  institution  which  does  not  eft'ectively  segregate. 


93 

County  24,  Case  15.  Mary,  10  years  old,  is  a  slight,  pretty  girl  of 
medium  height,  blue  eyes,  and  pink  and  white  complexion.  She  seemed 
diflSdent  at  first,  because  she  had  recently  lost  almost  all  of  her  pretty 
light  brown  hair.  However,  her  shyness  soon  wore  off  and  she  proved  to 
be  an  appealing,  acquiescent  sort  of  child,  with  a  ready  smile  and  a 
good  deal  of  charm.  Her  physical  history  was  negative,  until  about 
the  time  she  was  brought  to  the  County  Infirmary,  when  it  was  found 
she  had  syphilis,  and  could  not  be  sent  directly  to  the  Adrian  Industrial 
Home,  where  she  had  been  committed.  She  was  receiving  treatment  at 
the  County  Infirmary  and  showed  nmrked  improvement. 


COUMTY  2.4.   Coee.lS. 

fu^ 

County  42.  Case: 9. 

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, ft) 

£-0 

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(£) 

(— ^ 

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Jail       '     Jail 

cy--4 

15 

LS.R              '^/     ""x             ^■^■^- 

/    NOv^   In     * 

I.SP.                               I.S.P. 

• 

CHART  7. 

The  great-grandmotlier  (9),  wlio  is  in  ono  County  Infirmary  In  the  state  is  the  first  of 
four  generations  o£  women  who  are  sexually  irresponsible,  the  youngest  of  whom  (15)  is  in 
an  adjacent  County  Intiruiary.  Four  of  the  men  who  have  cohabited  with  her  are  in  the 
Ionia  Reformatory.  (For  explanation  of  symbols  used  in  the  above  chart  see  first  chart  in 
Appendix.) 


Mentally,  the  Binet  Test  showed  her  to  be  about  ten  and  a  half  years 
old.  In  the  judgment  of  the  investigator  this  was  a  fair  index  of  her 
mental  development.  She  proves  to  be  easy  to  manage  at  the  County 
Infirmary,  helps  with  tlie  work  when  forced,  but  is  inclined  to  be  lazy. 
In  talking  of  her  sexual  irregularities  she  is  very  frank.  Although  she 
seems  to  realize,  in  a  vague  way,  that  she  did  wrong,  she  disarms  one 
by  asking  ''why  her  mother  should  have  let  such  things  go  on  if  they 
were  wrong." 

In  spite  of  the  fact  that  she  inherently  lacks  moral  stamina  and  power 
to  resist  temptation,  undoubtedly  her  plea  is  fair  and  her  background 
has  much  bearing  on  her  case. 

Little  is  known  of  her  father  except  that  he, sensed  two  years  in  the 


94 

Jackson  State  Prison  for  chicken  thieving.  When  he  came  home  and 
found  his  wife  living  with  another  man,  he  walked  out  and  has  not  been 
back  since.  There  is  little  doubt  that  Mai'y's  mother  is  promiscuous 
sexually.  She  was  also  convicted  of  chicken  thieving,  but  the  case  was 
dismissed  because  of  her  small  children.  She  was  subsequently  sent  to 
jail  for  violation  of  the  compulsory  school  law  and  later  arrested  for 
"disorderly  conduct." 

It  was  interesting  to  find  in  visiting  another  County  Infirmary  that 
her  grandmother,  Mary's  great-grandmother  was  a  resident  there.  She 
verified  a  number  of  the  facts  in  regard  to  her  granddaughter,  as  well 
as  in  regard  to  her  own  daughter,  who  was  irresponsible  sexually,  with 


County   72.. 
Cases   14-15. 

half     sisters 

• 
0 

^H_                J—T_ 

i^ 

dCol.      } 

^u 

1            lU        M5 

c 

y 

oreo 

CHART  ^£. 

This  high  grade  imbecile  girl  (15)  is  the  illegitimate  offspring  of  two  feebleminded  parents, 
one  of  whom,  her  mother,  died  in  the  County  Infirmary.  (For  explanation  of  the  symbols 
the  above  chart  see  first  chart  in  Appendix.) 

specific  history  at  one  time.  Her  son,  she  at  length  reluctantly  told  the 
investigator,  had  got  "mixed  up  with  another  man's  wife,  shot  her  and 
liimself, — it  was  a  famous  murder  case  in  its  dav." 

It  is  not  surprising  then  to  find  Mary  committed  to  Adrian  for  sexual 
immorality.  Four  of  the  men  are  now  in  the  Ionia  Reformatory  for 
statutory  rape  while  one  is  still  awaiting  his  trial.  Since  the  interview 
with  the  investigator,  Mary  has  been  taken  to  the  Adrian  Industrial 
Home  for  Girls.  When  one  considers  that  Mary  is  a  feebleminded  girl 
of  the  moron  type,  it  would  seem  that  such  a  disposition  of  the  case  is 
a  grave  error  in  judgment. 

County  72,  Cask  15.    This  girl  shows  many  of  the  same  characteristics 


95 

of  the  moron  jjirl.  However,  by  the  Binet  Test,  she  has  only  the  men- 
tality of  a  child  of  seven,  which  puts  her  in  the  high  grade  imbecile  class. 
She  is  a  slight,  fairly  pretty  girl  except  for  a  receding  chin,  which 
makes  her  face  extremely  weak.  She  had  a  soft,  appealing  voice  and 
constantly  excused  her  failures  to  answer  the  questions  by  saying  she 
''never  had  any  education,  she  wished  she  could  get  out  of  here  and  get 
some  education."  Although  one  sympathized  with  her  plea,  it  was 
impossible  to  believe  in  her  sincerity,  and  her  history  verified  this  im- 
pression. 


County  I4-. 
Case  Z. 


ISP. 


■0 


CHART  4-. 

This  feebleminded  girl  (2)  with  the  mentality  of  a  child  of  9%  years,  has  already  bad 
an  illegitimate  child  born  at  the  County  Infirmary  by  her  cousin.  She  in  turn  is  one  of  two 
illegitimate  children  her  insane  mother  had  by  her  own  epileptic  father,  while  her  feeble- 
minded husband  was  in  the  Jackson  State  Prison.  This  girl's  own  brother  has  been  to  the 
Lansing  Industrial  School  while  two  of  her  half-sisters  were  taken  from  the  County  Infirmary 
to  the  State  Public  School  a  number  of  years  ago.  (For  explanation  of  the  symbols  used  in 
used  in  the  above  chart  see  first  chart  in  Appendix.) 


Bora  at  the  County  Infirmary  and  having  spent  her  life  there,  she 
had  had  little  chance  of  any  sort  in  the  world.  Within  the  last  year, 
however,  she  had  proven  herself  a  particular  menace  to  the  institution 
and  to  society  and  should  certainly  be  removed  to  an  institution  with 
more  custodial  facilities.  Four  times  has  she  set  fire  to  the  building, 
and  twice  has  .she  escaped  from  the  infirmary  with  different  male  in- 
mates, with  each  of  whom  she  had  intercourse.  She  has  also  been  caught 
cohabitating  with  two  other  inmates,  one  a  feebleminded  man,  and  one 
an  old  man  who  is  a  case  of  senile  dementia.  Fortunately,  there  has 
been  no  evidence  of  pregnancy,  but  it  is  a  possibility  which  certainly 
should  be  guarded  against. 


9G 

Her  heritage  is  one  of  the  worst.  Her  mother  was  of  a  hij>Iier  grade 
of  feeblemindedness  than  she,  neat,  pretty,  attractive,  but  lacking  ability 
to  inhibit  the  sexual  impulse.  She  was  in  the  County  Infirmary  several 
times,  once  to  give  birth  to  the  feebleminded  daughter  who  is  perpetu- 
ating her  anti-social  qualities.  The  child's  father  was  probably  a 
feebleminded  man,  so  there  is  small  wonder  that  the  girl  is  one  whom 
we  feel  should  be  immediately  transferred  to  an  institution  especially 
adapted  to  her  care. 

The  facts  presented  in  relation  to  the  two  cases  just  described  give  an 
idea  of  the  predominance  of  the  sexual  element  in  the  lives  of  these 
feebleminded  girls.     Tt  may  be  quite  generally  stated  that  the  higher 


COUNTV   16- 
Cases   n-i6. 


& 


□^xS^^J^^5%PSjo^^     ^ 


I     I 


^    iK&T      O    □   ©   6-r-     (Z)   ®-r- 


[§ 


/        Col.  j 


F? 


^^ 


I 

6 


o 


bCo.I. 


CHART  5. 

This  feebleminded  girl  (7)  is  the  result  of  the  unrestrained  sexual  impulse  of  a  feeble- 
minded brother  and  sister.  The  brother  is  seen  to  have  had  a  legitimate  union  resulting  in 
feeblemindedness  and  dependency  while  the  mothei-'s  further  relationships  show  illegitimacy 
and  possible  defectiveness. 

The  parent's  uncle  (16)  is  in  the  County  Inflrmary  while  other  members  of  their  strain 
show  feeblemindedness  and  sexual  irresponsibility.  (For  explanation  of  the  symbols  used  in 
the  above  chart  see  first  chart  in  Appendix,) 


grade  feebleminded  girl  has  strong  sexual  desires,  with  practically  no 
inhibitoi-y  power,  and  it  is  generally  as  a  result  of  this  weakness  that 
she  finds  her  way  into  the  County  Infinnary.  It  is  this  fact  that  ac- 
counts for  the  large  ]iercentage  (30%)  of  unmarried  feebleminded 
women  in  the  County  Infirmaries  who  had  had  children,  'that  the  unmar- 
ried feebleminded  woman  and,  as  well,  the  feebleminded  woman  who  co- 
habits with  men  other  than  her  husband,  contributes  largely  to  the  de- 
pendent class  is  shown  by  charts  4.  5,  15,  20,  24. 


97 

However,  it  must  not  be  thought  that  the  children  of  the  unmarried 
feebleminded  woman  are  any  more  of  a  burden  to  the  community  than 
those  of  the  married  woman  of  this  same  type.  That  the  results  of  a 
legalized  marriage  are  no  less  disastrous  to  the  community  is  clearly 
demonstrated  by  Charts  1,  18. 

Yet  we  are  continually  allowing  such  marriages  to  take  place.  We 
are  not  only  allowing,  we  are  aiding  and  abetting.  In  County  13,  the 
investigator  noticed  this  entry  on   the  infirmary  record,   "Mary  Doe, 


County  53. 
Cose  15. 


Bh 


dTSH. 


<D 


SRS. 
Lopeer 
H.»T.&. 


dCoI. 


CHART  15. 

Altbougb  there  are  few  Individuals  represented  on  this  chart,  it  would  seem  as  though 
there  was  sufficient  to  indicate  that  some  different  means  of  caring  for  the  inmate  inter- 
viewed (15)  should  be  provided.  Her  father  died  Insane  at  the  Traverse  City  State  Hospital 
and  her  mother  is  feebleminded.  Her  older  brother,  a  resident  of  the  County  Infirmary  and 
the  state  Public  School,  is  now  in  the  Lapeer  Home  and  Training  School  and  the  girl  her- 
self, of  a  mental  age  of  about  5  years,  has  had  two  illegitimate  children  born  at  the  County 
Infirmary  and  sent  to  the  State  Public  School.  The  father  of  one  Is  unlcnown,  while  the 
father  of  the  other  was  a  feebleminded  man  who  died  in  the  County  Infirmary.  (For  expla- 
nation of  symbols  used  In  the  above  chart  see  first  chart  in   Appendix.) 


Feebleminded."  After  this  entry  was  given  the  date  on  which  she  was 
removed  from  the  infirmary  by  the  supervisor  from  her  township  "to 
get  married."  The  history  of  this  particular  case  could  not  be  traced, 
but  it  is  known  that  this  county  is  paying  highly  for  its  shortsighted- 
ness. Over  50  per  cent  of  the  people  its  taxpayers  are  supporting  in  the 
County  Infirmaries  are  either  feebleminded  or  epileptic.  Chart  3  shows 
how  this  County  is  burdening  itself  with  defectives  and  dependents. 

The  entry  record  quoted  above  was  of  a  happening  of  several  years 

ago.    And  while  it  is  felt  that  spch  instances  of  shortsightedness  on  the 

part  of  the  oflficials  dealing  with  the  dependent  defective  are  becoming 

less  frequent,  yet  similar  instances  are  still  to  be  found.    In  County  43 

13 


98 

there  was  a  case  in  point.  (See  Chart  13.)  Here  was  a  feebleminded 
girl  with  the  mentality  of  a  child  7%  years  of  age  who  had  come  to  the 
infirmary  three  years  previously  to  give  birth  to  an  illegitimate  child. 
Recently  she  had  been  courted  by  a  man  of  questionable  mentality,  who 
had  some  property  and  was  offering  to  marry  her.  It  seems  incredible 
that  in  the  summer  of  1914  she  was  discharged  from  the  county  books 
"to  get  married."  A  similar  case  was  noted  in  County  38.  Case  51, 
where  a  feebleminded  girl  who  tested  0  years  of  age  mentally  was  dis- 
charged June  6,  1914,  "to  get  married." 


COUNTV    70. 
Cose  1. 


d.Co.I. 


D 


O 


■D 


Col 
dRS.H. 


-n 


:-a      n 


Co.1.      Col.     Col 
Lapeer    Lopcer 
H.iTS.     HiTS 


bCal.      Col       bCoI. 

SRS.     SPS.    dCol. 
Lapeer    Lapeer 

H.-«T&.     hWTS 


CHART  ZO. 

The  father  of  this  woman  died  lu  the  County  Infirmary  and  her  mother  was  taken  from 
the  County  Infirmary  to  the  Pontiac  State  Hospital,  where  she  died  insane.  She  herself  tests 
by  the  Binet  5  4/5  years  mentally  and  is  about  42  years  old.  By  six  different  and  unknown 
men,  she  has  given  birth  to  six  boys,  all  of  whom  have  been  in  the  County  Infirmary  at  some 
time  In  their  lives  and  two  of  whom  were  born  there.  Four  of  these  boys  are  now  in  the 
Lapeer  Home  and  Training  School,  one  is  dead  and  one  she  has  lost  track  of.  (For  ex- 
planation of  the  symbols  used  in  the  above  chart  see  first  chart  in  Appendix.) 


And  again  in  County  75,  we  find  the  case  of  a  feebleminded  woman 
whom  the  authorities  would  not  allow  to  be  married  because  the  suitor 
ivould  not  pledge  half  of  his  property  to  her  support.  The  prolificacy 
of  such  a  marriage — and  of  the  marriage  which  will  probably  take  place 
as  soon  as  the  authorities  can  find  a  man  who  will  buy  his  right  to  the 
woman  by  relieving  the  county  of  her  keep,  can  be  seen  by  Chart  23 
which  shows  the  number  of  children  she  has  already  borne. 

This  woman  represents  a  very  common  type  of  the  moron.  And  the 
picture  which  the  investigator,  Miss  McKinnie.  has  given  of  this  case 
depicts  the  type  so  well  that  it  is  here,  given  in  detail. 


99 

"Maggie." 

County  75j  Case  39.  Maggie  is  a  roiiud,  diimpj-  woman  with  an  ex- 
pansive figure  Avhicli  she  has  never  attempted  to  corset.  Her  eyes  are 
bright  and  twinkling  and  brown,  and  her  hair  is  drawn  back  in  a  tight 
disregard  of  both  beauty  and  fashion.  She  takes  you  into  her  confi- 
dence directly  and  in  the  most  simple  and  natural  way  conceivable.  I 
visited  her  at  the  County  Infirmary  where  she  has  lived"  "off  and  on"  for 
the  last  eleven  years.  By  the  Binet  Test  she  proved  to  have  a  mentality 
of  a  girl  of  nearly  eleven  years.    P^veryone  there  has  become  fond  of  her. 


CouNxv    77. 
Case  1. 


Co.I. 


b.Co.r.        b.CoI 
dCal.      dCoI 


b.Co.1. 
d.Co.I. 


CHART  ZA-. 

This  feebleminded  woman,  two  of  whose  consorts  were  inmates  of  the  County  Infirmary, 
has  had  six  illegitimate  children,  five  of  whom  were  born  in  the  County  Infirmary.  (For 
explanation  of  the  symbols  used  in  the  above  chart  see  first  chart  in  Appendix.) 


she  writes  letters  for  the  other  inmates,  helps  care  for  the  sick  and 
watches  with  the  dead.  And  if  she  has  sulky  spells  or  sudden  bursts  of 
temper,  everyone  realizes  that  it  is  just  Maggie,  who  has  never  con- 
trolled an  impulse  in  her  life.  For  Maggie  expresses  her  philosophy  in 
her  own  words:  "I  believe  in  letting  what's  natural,  be  natural,"  with 
an  emphatic  nod  of  her  head,  so  convincing  that  you  wonder  if  perhaps 
that  is  not  best  after  all.  But  maturer  deliberation  makes  us  feel  sure 
that  Maggie  is  not  the  sort  of  mother  we  want  for  the  next  generation, 
in  spite  of  her  propensity  to  perform  that  highest  of  functions.  For 
Maggie,  mother  of  five  illegitimate  children  by  five  different  father's,  at 
thirty-four,  wants  a  nice  German  husband  to  make  a  home  for  her  and 
the  possible  unborn  "Maggies."  And  the  good  people  caring  for  her 
are  wishing  for  her  the  same.  Does  her  history  warrant  such  a  venture? 
Maggie  is  the  first  of  three  illegitimate  children  her  mother  had  by 


100 

diflferent  men,  before  she  married  the  old  feebleminded,  degenerate  Ger- 
man she  is  living  with  now,  and  Avho  supposedly  is  the  father  of  her  last 
four  children.  Maggie's  father  was  killed  before  she  was  born,  walk- 
ing home  one  night  along  the  tracks  so  drunk  he  did  not  hear  the  train 
coming.  So  the  responsibility  of  her  upbringing  fell  upon  a  feeble- 
minded mother,  and  Maggie  was  given  over  to  the  care  of  any  one  who 
wanted  a  baby  girl.  After  several  people  had  had  her,  she  was  sent 
to  the  State  Public  School,  and  from  there  was  sent  to  a  number  of 
homes  in  all  of  which  she  was  unsatisfactory,  for  one  reason  or  another. 


County  7. 

Cases:  6,7.8.9.10.11,12. 


Co.  I. 


O 


©WW^ 


E 


a.  CJJ 


IjQpeer      f  f  f 

H.»TS. 
S.PS. 


CHART  I. 

This  shows  two  feebleminded  sisters  (No.  10  and  6)  coming  of  a  defective  family  marry- 
ing two  brothers,  one  of  whom  is  feebleminded.  These  men  were  unable  to  support  their 
families,  who  had  been  at  another  County  Infirmary  before  coming  to  the  one  in  which  they 
were  interviewed,  and  so  had  brought  their  wives  and  children  to  the  County  Infirmary  and 
had  left  the  county.  The  oldest  child  in  each  of  these  families  had  been  sent  to  the  State 
Public  School  and  one  of  these  is  now  at  the  Lapeer  Home  and  Training  School.  The  other 
Ave  children  in  these  two  families  are  at  the  County  Infirmary  with  their  mothers.  The 
oldest  of  these  children  is  six,  decidedly  feebleminded  and  has  since  been  taken  to  the  Lapeer 
Home  and  Training  School.  (For  explanation  of  the  symbols  used  in  the  above  cliart  see 
first  chart  in  Appendix.) 


One  of  her  reports  states  that  the  man  "can't  bear  to  have  her  touch  him, 
but  does  not  mind  her  being  around."  So  finally  she  went  to  live  with 
her  mother  and  step-father,  who  were  getting  along  the  best  they  could, 
doing  as  little  work  as  possible.  It  was  while  she  was  here  that  her 
step-father  used  to  come  and  "sleep  with  her  and  her  half-sister,  Mary." 
"Well,  but  3Iaggie,  did  your  mother  know  he  did?"  I  asked.  "Oh,  yes," 
she  said,  "she  knew,  but  I  guess  she  was  glad  to  get  rid  of  him." 

One  day  a  peddler  came  along  and  begged  a  night's  lodging,  which 
was  accorded  him  hospitably.  And  in  the  course  of  time,  Maggie  was 
taken  to  the  County  Infirmary,  where  Kalph  was  born.    "And  did  Ralph 


»    »^    *    e    • 
»    •  -  *    •     ^ 


101 


^    '  t    »      .*»••••     -» 

live?"  I  asked.  "No,"  Maggie  replied  regretfully.  "He'  lia'd  spasms 
when  he  was  ten  days  old  and  died.  His  father  wasn't  very  bright,  but 
he  had  to  pay  the  county  house  two  hundred  dollars." 

"And  what  happened  to  you  next,  Maggie?"  Maggie  settled  herself 
with  satisfaction  at  having  found  an  interested  listener.  She  continued, 
"Well,  I  went  to  work  at  a  place  in  another  county,  and  then  I  saw  him." 
"Whom?"  "Why,  John.  He  was  the  hired  man  where  I  worked.... 
Claribel  was  born  here,  and  she  was  a  nice  bright  child  when  I  last  saw 
her — only  that  was  twelve  years  ago  when  she  was  a  baby,  and  taken 


County  62!. 

Cases    3-4-5-6. 


H.of.Cor. 


Jail 


# 


F? 


CHART  18. 

When  the  feebleminded  father  of  these  four  feebleminded  children  returned  from  the  De- 
troit House  of  Correction  he  deserted  his  feebleminded  wife,  who  is  a  cousin,  and  who  is 
now  being  cared  for  by  a  defective  brother.  The  oldest  boy  was  tested  in  the  county  jail 
where  he  was  awaiting  his  commitment  to  the  Lapeer  Home  and  Training  School.  The 
other  four  children  (3,  4,  5,  6,)  are  at  the  County  Infirmary.  The  older  three  of  these  are 
feebleminded  and  the  youngest  is  too  young  to  Judge.  (For  explanation  of  the  symbols  used 
in  above  chart  see  first  chart  in  Appendix.) 


to  Coldwater.  I  don't  know  where  she  is  now."  And  Maggie  beamed 
with  pride  at  the  thought  of  her  second  offspring. 

Then  Maggie  went  to  work  for  Mr.  Mitchell  on  his  farm,  and  a  shadow 
crossed  her  face.  "He  was  awful  mean,  he  was.  I  Avorked  awful  hard 
for  him,  from  early  in  the  morning  until  late  at  night— whatever  he 
wanted  done.  Sometimes  in  the  fields  or  in  the  barn  or  sometimes  in 
the  house  for  his  wife.  But  she  never  knew  he  used  me  whenever  he 
wanted  to.  He  used  me  just  like  an  animal— and  he  took  good  care  too, 
that  I  shouldn't  get  into  trouble." 

One  day,  however,  when  Maggie  was  in  the  fields,  a  big,  alcoholic 
German  came  along,  and  a  few  minutes  together  resulted  in  a  miscar- 


102 

riage  three  months  later.  However,  she  was  able  to  keep  this  fact  from 
Mr.  Mitchell  and  his  wife,  so  that  things  went  along  nndistnrbed  for 
eight  years  there.    "Peter  came  to  be  the  hired  man,  and  one  day  when 

I  was  milking  cows,  he  came  into  the  bam and  I  just  leit  him." 

'•But  n-hi/  did  you,  Maggie?''  "Oh.  I  don't  know,"  she  said  reminiscently. 
After  a  pause — "Do  you  suppose  I  will  go  to  heaven  if  I  am  awful  good 
to  the  old  ladies  here  all  the  rest  of  my  life  to  make  up?"  "Well,  what 
happened  then?"  I  prodded  her  to  resume  her  narrative.  "Well, 
Mitchell  was  awful  mad  when  he  found  it  out.    I  thought  he  would  kill 


County  15. 

CoeeZ-T 


¥ 


-<3) 


fl 


CHART  3. 

This  chart  shows  a  woman  in  the  first  generation  who  was  probably  feebleminded  having 
eight  feebleminded  children,  the  oldest  of  whom  was  Interviewed  (27).  Four  of  these  feeble- 
minded daughters  each  had  at  least  one  Illegitimate  child,  all  of  whom  were  in  the  County 
Infirmary  and  the  State  Public  School.  It  is  known  that  one  of  these  grandchildren  has 
reached  Lapeer.  So  it  is  seen  the  County  has  paid  dearly  for  the  support  of  at  least  9  of 
this  feebleminded  woman's  progeny,  to  say  nothing  of  the  share  the  state  institutions  have 
had  to  bear.  (For  explanation  of  the  symbols  used  in  the  above  chart  see  first  chart  in 
Appendix.) 


me.  Then  he  sent  me  to  Peter's  house,  and  I  just  walked  right  in  and 
his  Avife  and  children  were  there, — but  I  didn't  care — and  I  just  told 
them  all,  what  trouble  he'd  got  me  into.  He  sent  me  over  to  the  County 
House  and  gave  me  a  dollar  to  keep  my  mouth  shut."  It  Avas  needless 
to  ask  if  she  had,  so  I  asked  about  the  child.  "Oh,  she  was  bright,  and 
was  adopted  right  away." 

Maggie  was  warming  to  her  narrative  now  and  her  eyes  sparkled  at 
the  thought  of  her  next  escapade.  "I  was  working  in  the  country  aways 
and  he  drove  out.  He  was  a  swell  one.  He  took  me  for  a  drive  with  his 
hovse  and  buggy  and  that  was  the  only  time  I  saw  him.  I  just  couldn't 
help  that — he  had  such  a  lovely  buggy Well,  the  baby  didn't  live 


103 

very  long.  He  died  of  cholera  infantum  when  he  was  about  eight  months 
old."  And  Maggie  sighed,  more  I  think,  because  her  story  must  end 
here  than  because  of  her  son's  death. 

(Now  spring  fever  is  in  Maggie's  blood  and  she  says  she  is  going  to 
run  away  one  of  these  days  and  find  a  husband.  She  tried  to  last  fall 
but  was  found  before  she  got  very  far  down  the  railroad  track.  She 
has  had  two  offers  of  marriage  since  she  has  been  at  the  County  In- 
firmary; one  from  a  young  German  with  a  bit  of  property,  which  was 
refused  by  the  Board  of  Supervisors  iecause  he  refused  to  deed  half  of 


County  43. 

Co&e  €). 


D 


Couins 


o 


#r-    0       ^       ^ 

I  Chorge.  Oec^  Dumb 


iOwmb 
School 


6 


CHART  B. 

This  feebleminded  girl  has  one  sister  who  was  sexually  immoral  and  died  of  syphilis, 
another  sister  who  has  been  in  the  School  for  the  Deaf  and  Dumb  at  Flint,  while  the  two 
youngest  of  her  fraternity  are  feebleminded.  (For  explanation  of  the  symbols  used  In  the 
above  chart  see  first  chart  in  Appendix.) 


his  property  to  her.    But  Maggie  is  a  pressing  problem,  especially  when 
we  look  back  a  little  into  her  family  history. 

All  we  know  of  her  paternal  heritage  is  a  tendency  to  promiscuity  and 
alcoholism.  Her  mother  is  feebleminded,  irresponsible  sexually  in  her 
earlier  years  if  not  at  present.  Her  three  illegitimate  children  by  dif- 
ferent fathers  bear  witness  to  this  fact.  And  of  her  four  children  by 
the  degenerate  husband  she  is  now  living  with,  one  is  dead,  and  two  at 
least  are  feebleminded.  Facts  of  her  fraternity  are  not  easily  ascertain- 
able. She  has  one  brother  who  is  a  bad  drinker,  one  a  barber  and 
"bright"  (Maggie  says),  one  feebleminded  and  two  sisters  who  died. 
One  of  these  sisters  fell  in  the  well  and  drowned,  although  she  was 
eighteen  years  old,  "but  then  she  didn't  know  anything." 

Have  Maggie  and  her  strain  justified  her  philosophy  of  ^'naturalness?" 
How  long  are  we  to  aid  such  unions?    How  long  are  we  to  allow  them 


104 

to  take  place?  How  long  are  we  going  to  leave  the  feebleminded  women 
of  child-bearing  age  at  large  in  the  community,  or  only  ineffectual ly 
segregated  ? 

It  has  previously  been  stated  that  there  were  in  the  County  Infirmaries 
of  Michigan  137  of  this  class  of  feebleminded  women.  These  residents  at 
the  infirmaries  are  not  effectively  segregated.  The  separation  of  the 
sexes  is  often  not  strict,  nor  are  the  women  always  prevented  from  co- 
habiting with  men  outside  of  the  institution.  Nor  is  the  segregation 
permanent.    The  feebleminded  inmates  come  and  go.   Of  the  328  women 


County  7  5. 
Case  39. 


^ 


tl  OES       D-1 


Q-Q^r  ^^K^iQi-n 


iQ 


b.Cal. 
dCoL 


bCoI. 
5.PS. 


bCoI    bCal 
dCol. 


CHART  23. 

For  story  of  persons  represented  in  this  chart  see  page  99. 

The  central  figure  is  that  of  Maggie  (39),  the  illegitimate  child  of  a  feebleminded  mother, 
who,  herself,  has  had  four  illegitimate  children  liorn  in  the  County  Infirmary.  (For  explana- 
tion of  the  symbols  used  in  tue  above  chart  see  first  chart  in  Appendix.) 


in  the  Feebleminded  Group  in  the  infirmaries,  117  had  had  one  previous 
admission,  40  had  had  two,  13  three,  19  four,  10  five,  and  26  over  five 
previous  admissions. 

It  has  been  shown  in  this  report  by  the  text  and  charts  that 
the  feebleminded  problem  is  quite  distinctly  a  state  problem.  It  has 
been  stated  that  nearly  one-half  (45%)  of  all  the  feebleminded  in  the 
County  Infirmaries  were  born  in  Michigan,  while  of  these  60  per  cent 
were  bom  in  the  county  which  is  now  supporting  them.  We  see  that  the 
state,  even  that  each  county,  is  very  largely  breeding  its  own  feeble- 
minded individuals. 

Until  the  state  and  local  authorities  realize  the  extent  of  the  burden 
they  are  incurring,  and  squarely  face  the  situation,  we  shall  continue 
allowing  the  defective  to  beget  defective  and  we  shall  continue  to  sup- 


105 

port  their  ofifspring.     Few  people  realize  how  disproportionately  much 
the  Feebleminded  Group  in  our  County  Infirmaries  are  costing  us. 

Each  one  of  the  1,974  individuals  in  the  Normal  Group  had  been  a 
resident  at  the  County  Infirmary  on  an  average  of  3.23  years,  while  the 
average  residence  of  each  of  the  710  feebleminded  individuals  was  9.32 
years.  The  actual  average  cost  in  monies  expended  in  current  expenses 
for  each  of  the  normal  individuals  was  |552.72.  The  average  cost  for  each 
of  the  feebleminded  individuals  was  ^1,419.11.  The  710  feebleminded 
who  were  in  the  County   Infirmaries  of    the    State    of    Michigan    at 


County  42.. 
Cades.  33,^0. 


(i"-) 


TCTbr 


^^>r^ 


/ 


u 


Qenero+ions 
I. 


(^Tcra 


Co.  I. 
Lapeer 


~6   S--;0    i-#y8 


ni 


H.ofC.       d.Co.I.\ 


D 


I 
I 


{kCo.1.  I    / 


CHh       Bt 


dCal. 


(b 


0     0       " 


Cal-  d.  Lapeer 

H.-»T.S. 


Cal      Cal. 


© 

Lapeer 
H.»TS 


V. 


Cal.      Cal. 
SPS.       S.R& 


CHART  12. 

This  chart  shows  two  Individuals  (20,  3.^)  who  were  interviewed  in  the  County  Infirmary. 
However,  the  maintenance  in  the  County  Infirmary  of  all  the  members  of  this  family  has  ap- 
proximated $17,573.97.  This  is  exclusive  of  the  cost  to  the  State  of  members  who  have  been 
in  other  Institutions.*  (For  explanation  of  the  symbols  used  in  the  above  chart  see  first 
chart  in  the  Appendix.)  ^  _,     ,.. 

•Note  :  This  is  part  of  a  chart  appearing  in  the  Report  to  the  State  Board  of  Health, 
but  is  presented  here  with  more  complete  data  in  regard  to  the  county. 

the  time  these  infirmaries  were  visited  by  this   Commission's  investi- 
gators have  already,  simply  in  their  expenses  as  residents  in  the  County 
Infirmaries,  cost  the  public  over  one  million  dollars.     (See  Table  56.) 
Moreover,  Chart  12  shows  a  family  which  has  cost  the  state,  for  main- 
tenance in  its  County  Infirmaries  alone,  over  |17,500.00.    (See  Table  57.) 

Summary  and  Conclusions. 

In  Michigan,  as  elsewhere,  it  has  been  found  that  juvenile  delinquency 
and  feeblemindedness  are  closely  inter-related. 

As  a  result  of  a  very  conservative  judgment  of  a  series  of  mental 
tests  it  has  been  found  ^that  one-fourth  of  the  boys  in  the  Lansing  In- 
dustrial  School,  and  one-third   of  the  girls   in   the  Adrian   Industrial 


106 

Home  are  clearly  feebleminded.  At  least  one-tenth  more  of  the  boys 
and  one-third  more  of  the  girls  are  so  markedly  subnormal  as  to  leave 
grave  doubt  of  their  ever  attaining  a  sufficient  mental  development  to 
enable  them  to  cope  successfully  with  the  ordinary  conditions  of  life. 

Further:  A  careful  study  of  the  occupational  histories  of  the  juvenile 
delinquents  resulted  in  showing  that  those  with  defective  mentality  had 
proven  less  reliable  and  had  been  found  less  frequently  in  positions  re- 
quiring capacity. 

The  histories  of  the  feebleminded  delinquents,  and  especially  of  the 
feebleminded  delinquent  girls,  have  shown  them  to  be  more  sexually  ir- 
responsible than  were  the  normal  delinquents. 

The  school  histories  of  the  juvenile  delinquents  have  shown  that  the 
feebleminded  were  more  irregular  in  school  attendance  and  less  pro- 
ficient in  their  school  work  than  were  the  normals. 

We  have,  then,  in  our  two  reformatories  for  juvenile  delinquents,  a 
large  percentage  of  individuals  who,  because  of  inherent  mental  re- 
tardation, are  incapable  of  reformation.  The  presence  of  this  large 
group  means  a  clogging  of  the  machinery  of  refonnation.  The  mere 
problem  of  the  control  and  discipline  of  this  class  is  so  excessive  as  to 
supersede  the  problem  of  reformation. 

Educational  authorities  agree  that  the  presence  of  backward  and  de- 
fective children  in  a  school  group  retards  the  progress  of  the  normal 
children  in  that  group.  Yet,  in  the  school  work  Avhich  our  juvenile  re- 
formatories are  endeavoring  to  continue  for  the  children  in  their  charge, 
we  find  that  they  are  forced  to  deal  with  a  group  in  which  from  one- 
third  to  three-fourths  are  feebleminded  or  subnormal. 

So  long  as  we  allow  these  conditions  to  exist,  so  long  as  we  permit 
the  feebleminded  delinquents  to  be  treated  in  the  same  institutions 
with  the  normal  delinquents,  just  so  long  shall  we  find  that: 

The  success  of  the  educational  work  in  these  institutions  will  be 
lessened ; 

The  possibility  of  reformation  will  be  lessened; 

The  results  of  the  reformatory  treatment  of  the  feebleminded  delin- 
quents will  be  nil,  while, 

The  chances  for  final  reinstatement  of  the  normal  delinquents  as 
capable,  law-abiding  members  of  society  are  immeasurably  decreased. 


In  Michigan,  as  elsewhere,  it  has  been  found  that  dependency  and 
mental  defectiveness  are  closely  inter-related. 

In  the  County  Infirmaries  of  this  state  one-fourth  of  all  the  inmates 
have  been  found  to  be  either  feebleminded  or  epileptic,  two-fifths  were 
either  insane  or  mentally  defective. 

It  has  been  found  that  each  of  the  feebleminded  individuals  has  been 
maintained  at  public  expense  in  the  County  Infirmaries  for  a  period 
three  times  as  long  as  has  each  normal  individual. 

It  has  been  found  that  the  feebleminded  women,  both  married  and 
unmarried,  at  present  resident  in  our  County  Infirmaries,  have  added 
large  numbers  to  our  dependent  defective  class. 

It  has  been. found  that  the  children  of  these  women  have  been  cared 
for,  not  only  in  the  County  Infirmaries  at  county  expense,  but  that  they 


107 

have  also  been  cared  for  in  various  state  institutions  at  the  expense  of 
the  state  as  a  whole. 

It  has  been  found  that  there  are  in  our  County  Infirmaries  137  feeble- 
minded women  of  child-bearing  age  who  are  neither  effectively  nor  per- 
manently segregated.  That  there  are  at  least  133  feebleminded  girls 
at  the  Adrian  Industrial  Home,  who,  on  reaching  the  age  of  21  can  no 
longer  be  retained,  but  will  be  discharged  into  the  community  at  large, 
potential  mothers  of  feebleminded  children.  That  there  are  on  the  wait- 
ing list  of  the  Lapeer  Home  and  Training  School  50  feebleminded  women 
of  child-bearing  age,  who  are  not  segregated  in  any  public  institution. 

While  this  Commission,  because  of  the  limits  of  time  has  been  unable 
to  determine  the  number  of  feebleminded  living  at  large  in  the  com- 
munity, yet  it  is  confident  that  this  number  is  large.  One  of  the  Com- 
mission's investigators  found,  in  one  family,  living  in  a  rural  community, 
five  feebleminded  women  of  child-bearing  age. 

Until  we  make  adequate  provision  for  the  care  of  the  feebleminded, 
especially  of  the  feebleminded  women  of  child-bearing  age,  we  are  going 
to  continue  producing  feebleminded  children. 

And  this  continued  production  means  not  only  an  increase  of  the 
number  of  defectives  to  be  supported  at  public  expense.  It  means,  also, 
the  increase  of  an  unsocial  class,  an  increase  in  crime  and  in  sexual 
immorality. 


RECOMMENDATIONS. 

In  view  of  the  facts  shown  in  this  report,  the  Commission  makes  the 
following  recommendations : 

1.  In  view  of  the  excessive  amount  which  the  foreign  population,  in 
proportion  to  its  numbers  in  Michigan,  contributes  to  the  insane  and 
mentally  defective  class,  it  is  urged  that  a  more  effective  control  and 
supervision  be  maintained  by  State  and  Federal  authorities  over  foreign 
immigration. 

2.  In  view  of  the  fact  that  matters  relating  to  the  insane  and  men- 
tally defective  are  essentially  problems  of  the  state  as  a  whole,  rather 
than  the  individual  counties,  it  is  desirable  that  the  state  maintain  a 
more  centralized  control  and  supervision  of  all  institutions  having  cus- 
tody and  treatment  of  the  insane  and  those  mentally  defective  or 
epileptic. 

3.  In  view  of  the  large  and  increasing  number  of  dii<charged  patients 
from  hospitals  for  the  insane  which  are  continuing  to  live  in  unrecovered 
mental  state  outside  of  institutional  care  and  in  view  of  the  absence  of 
any  contact  between  state  institutions  and  the  families  of  the  insane 
and  mentally  defective,  this  Commission  recommends  the  enactment  of 
a  law  providing  for  the  employment  of  a  field  worker  by  each  institu- 
tion and  the  continuance,  by  the  institution,  of  a  systematic  supervision 
over  those  who  have  been  discharged. 

4.  In  view  of  the  certain  knowledge  we  possess,  of  the  influence  of 
syphilis  in  the  production  of  insanity  and   physical  and  nervous  de- 


108 

generacy,  it  is  urged  that  continued  efforts  be  made  towards  bringing 
to  public  attention  the  dangers  from  this  disease. 

5.  In  view  of  the  known  influence  which  alcohol  has  in  the  produc- 
tion of  insanity,  and  conditions  of  physical  and  nervous  degeneracy, 
it  is  urged  that  the  public  be  educated  to  an  appreciation  of  the  dangers 
of  intoxicating  drinks. 

6.  It  is  recommended  that  a  law  be  enacted  providing  that  no  child 
be  admitted  to  any  of  the  state  institutions  caring  for  juvenile  delin- 
quents or  dependents,  without  a  mental  examination  being  made  by  a 
competent  person,  and  that  provision  be  made  for  the  employment  at 
each  of  these  institutions  of  a  person  specially  trained  for  this  purpose. 

7.  In  view  of  the  lack  of  any  centralized  statistical  consideration  of 
matters  pertaining  to  the  insane  and  mentally  defective  classes,  the  Com- 
mission recommends  the  enactment  of  a  law  requiring  all  institutions 
caring  for  these  classes  to  furnish  the  State  Board  of  Health  such  in- 
formation as  the  Board  may  require  concerning  these  classes  and  their 
relation  to  public  health;  that  the  State  Board  of  Health  continue  the 
statistical  investigations  carried  on  by  this  Commission  and  that  ample 
provision  be  made  for  this  work  and  that  the  statistics  be  published  by 
the  State  Board  of  Health  in  its  Annual  Keport. 

8.  In  view  of  the  continued  menace  to  the  public  health  from  the  in- 
crease of  the  feebleminded  and  insane  which  is  the  result  of  the  marriage 
of  those  who  are  insane  or  feebleminded  or  physically  diseased,  it  is 
recommended  that  a  law  be  enacted  making  it  obligatory  that  the  name 
of  each  individual  who  may  be  cared  for  in  a  public  or  private  insti- 
tution in  Michigan  in  which  are  treated  6r  held  in  custody  those  who 
are  insane,  delinquent,  dependent,  mentally  defective  or  epileptic,  be 
filed  in  the  office  of  the  State  Board  of  Health  by  the  Superintendent  or 
officer  in  charge  of  such  public  or  private  institutions.  Such  names  shall 
be  held  in  privacy.  Before  the  clerk  of  any  county  in  Michigan  may  issue 
a  license  for  marriage,  he  shall  submit  the  name  of  the  applicant  to  the 
Secretary  of  the  State  Board  of  Health.  If  any  information  is  in  the 
official  possession  of  the  State  Board  of  Health  which  shows  that  such 
individual  has  been  adjudged  insane  or  shown  to  be  feebleminded,  epi- 
leptic or  afflicted  either  with  active  or  latent  syphilis  or  gonorrhea, 
the  clerk  shall  be  so  informed  and  the  license  shall  not  be  issued. 

9.  In  view  of  the  following  facts, 

First,  That  the  laws  prohibiting  marriages  of  defectives  are  not  en- 
forced ; 

Second,    That  the  sterilization  act  is  infrequently  used; 

Third,  That  the  expense  of  segregation  may  be  decreased  by  its  appli- 
cation to  but  one  sex; 

Fourth,  That  the  feebleminded  women  play  a  more  definite  and 
tangible  part  in  the  problem  of  defectiveness  than  do  the  feebleminded 
men; 

And  in  view  of  the  facts  that 

First,  There  are  at  least  137  feebleminded  women  of  child-bearing  age 
in  County  Infirmaries  who  are  neither  effectively  nor  permanently  segre- 
gated ; 

Second,  There  are  at  least  131  feebleminded  girls  at  the  Adrian  In- 
dustrial Home  who  are  neither  subjects  for  reformatory  treatment  nor 
desirable  as  mothers  after  their  discharge; 


109 

Third,  There  were,  June  30,  1914,  50  feebleminded  women  of  child- 
bearing  age  on  the  waiting  list  of  the  Lapeer  Home  and  Training  School, 
whose  full  capacity  is  already  reached; 

We  recommend  that  some  adequate  state  provisions  be  made,  either  in 
the  establishment  of  a  special  institution  or  by  increasing  the  capacity 
of  the  Lapeer  Home  and  Training  School,  for  the  custody  of  the  feeble- 
minded women  of  child-bearing  age. 


APPENDIX. 


n 

Male 

LEGEND 

Inmate  Interviewed. 

/ 

O 

Female 

■ 

Residence  in  County  Infirmary 

o 

Sex  Unknown 

Cal. 

County  Infirmary 

• 

Miscarriage. 

S.PS. 

State  Public  School 

F 

Feebleminded 

Lapeer 

H.4T5. 

Lapeer  Homc»Training  5claool. 

I 

Insane 

K.SR 

Kolamazoo  State  Hospital. 

Na 

Neuro+ic 

PSH. 

Pontiac 

E 

Epileptic 

TSH. 

Traverse 

X 

X  mentality 

N.S.H. 

Nevv' berry 

5, 

Sexually  Immoral 

I.5.P 

Ionia     Stnte    Prison. 

CK 

Chorea 

H.ofC. 

Detroit  House o^  Correction. 

5ui. 

Suicide 

In  a  Public  Institution. 

In  the  above  plate  are  given  the  symbols  used  in  Charts  1-28  which  are  distributed  through- 
out the  body  of  the  text.  Beside  this  explanation  of  symbols,  the  following  explanation  will 
help  to  an  understanding  of  the  charts. 

The  symbols  used  are  explained  in  the  accompanying  legend.  Short  horizontal  or  oblique 
lines  connecting  two  symbols  denote  a  marriage.  The  long  horizontal  lines  suspend  symbols 
representing  the  children  in  one  family.  The  dotted  lines  indicate  non-conjugal  relationships 
with  their  illegitimate  offspring,  if  there  are  such. 

It  must  be  stated  that  all  these  charts  are  incomplete,  representing  only  those  Individuals  in 
a  family  about  whom  sufficient  information  was  obtained  to  justify  their  classification  as 
feebleminded,  Insane,  etcetera.  This  Information,  except  in  rare  cases,  was  not  obtained  by 
field  work,  but  by  careful  questioning  of  the  County  Infirmary  keepers,  inmates  and  occasion- 
ally persons  outside  the  institution.  These  incomplete  charts  are,  therefore,  only  Intended  to 
Indicate  the  possible  ramifications  of  defectiveness  and  dependency  and  a  field  wherein  further 
Investigation  would  prove  exceedingly  profitable. 


APPENDIX. 


TABLE  1. — Insane  in  Institutions  in  Michigan,  June  SO,  1914. 

Public  Institutions. 

Males. 

Females. 

Totals. 

Kalamazoo  State  Hospital                                

1,100 
724 
861 
520 
24 
396 
291 

1,011 
688 
656 
370 
31 
59 
299 

2,111 

Pontiac  State  Hospital 

1,412 

Traverse  Citv  State  HosDital                                                

1,517 

Newberry  State  Hospita  .                                   

890 

Psychopathic  State  Hospital 

55 

Ionia  State  Hospital 

455 

Eloise  State  Hospital 

590 

Total 

3,916 
249 

3,114 
158 

7,030 

Countv  Infirmaries. ...                            

407 

Private  Institutions. 
Dearborn  Retreat 

69 
17 
11 

131 
25 
13 

200 

Oak  Grove .... 

*42 

Society  for  Christian  Benevolence  for  Insane  and  Imbeciles 

24 

Total 

97 

169 

266 

Total  insane  in  public  and  private  institutions 

4,262 

3.441 

7,703 

♦Including  private  patients  from  other  states. 


TABLE  2. — (Diagram  I.)  —  Relation  of  increase  in  first  and  total  admissions  in  Michigan 
State  Hospitals  to  increase  in  total  population  of  State,  1901  to  1914- 


Year. 

First 
admission. 

Total 
admissions 

Population. 

1901 

793 

915 

1.126 

1.002 

1.051 

1,073 
1 ,005 
1,099 
1.177 
1.200 

1,206 
1.196 
1,199 
1,290 

1,115 
1,270 
1,514 
1,196 
1,567 

1,642 
1,597 
1,646 
1,729 
1,682 

1,674 
1 ,560 
1,613 
1,603 

2,459,901 

1902 

2,498,820 

1903 

2,537,739 

1904 

2,576,658 

1905 .  . 

2,615,577 

1906 

2,654,496 

1907 

2,693,415 

1908 

2,732,334 

1909 ; 

2,771,254 

1910        .      .                                                              

2,810,173 

1911                                                                            

2,849,092 

1912 .                 

2.888,011 

1913        .                                                                  

2.926,930 

1914                                                                    

2,965,849 

15 


114 

TABLE  3. — (Diagram  II.) — Total  number  and  ratio  per  10,000  receiving  treatment  at 
Michigan  Stale  Hospitals  during  each  biennial  period  1890  to  1914- 


Year. 

Number. 

Ratio  per 
10.000. 

1890 

3,652 
3,989 
4,247 
4,709 
4,868 

4,995 
5,519 
6,203 
6,695 

7,336 
8,027 
8,483 
8,955 

17   44 

1892 

18  47 

1894 

10  09 

1896 

20  56 

1898 

20  66 

1900 

20  63 

1902 

22  08 

1904 

24  07 

1906 

25  22 

1908 

26  84 

1910 

28 .  56 

1912 

29.34 

1914 

30   19 

TABLE  4. — Nativity  of  patients  admitted  to  the  Michigan  State  Hospitals  for  the  Insane, 

during  the  year  ending  August  31,  1914- 


Males. 

Females. 

Totals. 

Place  of  birth  unknown 

21 

14 

2 

69 

1 
21 

27 

3 

52 

14 

4 

14 

8 

3 

28 

17 

7 
14 

3 
11 

18 

7 

2 

70 

■1 

16 

0 

40 

11 

3 

11 

0 

4 

13 

15 

? 

1 
3 

39 

Austria 

21 

Belgium 

4 

Canada 

139 

Denmark 

2 

England — Wales 

35 

Finland 

43 

France 

3 

Germany — Prussia 

92 

Holland 

25 

Hungary 

Ireland 

25 

Italy 

8 

Norway ". 

T 

Russian  Poland 

41 

Russia 

32 

Scotland 

12 

Sweden ... 

21 

Switzerland ... 

4 

Other  Countries 

14 

Total  foreign  bom . 


312 


223 


535 


Total  native  born . 
Michigan 


Indiana 

New  York ... 

Ohio 

Penn.sylvania. 


New  Jersey . .  . 
New  England. 

Southern 

Western 


State  unknown. 


689 
441 


31 


510 

1,199 

330 

771 

16 

34 

51 

126 

42 

92 

11 

30 

2 

2 

6 

18 

8 

Ifi 

33 

68 

42 


115 


TABLE  5. — (Diagram  IV.) — Number  per  10,000  of  the  patients  of  different  nativities  ad- 
mitted to  Michigan  State  Hospitals,  Sept.  1, 1913,  to  August  31,  1914. 


Austria 

Belgium 

Canada 

Denmark 

England — Wales . 


Finland .  . 
France . . . 
Germany . 
Holland .  . 


Hungary . 
Ireland. . 
Italy.... 
Norway . 


Rus.sia  and  Poland . 

Scotland 

Sweden 

Switzerland 


6.7 
7.0 
8.1 
3.1 
8.0 

13.7 

12.4 

6.9 

7.5 

6.0 

12.2 

4.7 

9.1 

19.2 

12.0 

7.9 

14.3 


Total  foreign  born. 
Native  born 


8.9 
5.4 


TABLE  6. — Nativity  of  parents  of  patients  admitted  to  the  Michigan  State  Hospitals  for  the 
Insane,  during  the  year  ending  August  31,  1914- 


Males. 

Females. 

Total. 

Place  of  birth  unknown 

205 

26 

4 

160 

6 

87 

45 

9 

202 

39 
9 

87 

7 

9 

45 

30 

37 

36 

5 

12 

147 

25 
6 

146 
6 

107 

46 

9 

222 

42 
8 

99 

10 
47 
31 

52 

36 

8 

16 

352 

Austria 

51 

Belgium 

10 

Canada 

306 

Denmark 

12 

England — Wales 

194 

Finland 

91 

France 

18 

Germany — Prussia ... 

424 

Holland 

81 

Hungary 

17 

Ireland 

186 

Italy 

14 

Norway 

19 

Russian  Poland 

92 

Russia 

61 

Scotland 

89 

Sweden 

72 

Switzerland 

13 

Other  Countries 

28 

Total  foreign  born 

855 

923 

1,778 

Total  native  born 

713 

217 

27 
173 
98 
50 
10 

41 
13 
24 

60 

703 

173 

20 
219 
80 
48 
11 

47 
22 
19 

64 

1,416 

Michigan .• .  .  . 

390 

Indiana 

47 

New  York ; 

392 

Ohio.      . .        .                                                      

178 

Pennsvlvania ...                              

98 

New  Jersev 

21 

New  England  States                                                       

88 

Southern  States .                                

35 

Western  States 

43 

State  unknown  .                     

124 

116 


TABLE  7. — Summary  of  nativity  of  parents  of  patients. 


Both  parents  foreign  born 

One  parent  foreign  born 

Botli  parent.s  native  born 

One  parent  native,  one  unknown 
Both  parents  unknown 

Total 


783 
214 
590 
49 
137 


1.773 


TABLE  8. — (Map   1.) — Average  yearly  number  of  admissions  to  Michigan  State  Hospitals 
by  county,  for  the  ten  year  period  ending  June  SO,  1912. 


County. 

1* 

2t 

Alcona 

4.5 
5.0 
29.5 
7.4 
8.0 

2.7 

2.9 

13.0 

17.6 

6.8 

25.3 
15.8 
40.6 
9.8 
11.9 

11.9 

17.5 

3.3 

9.0 

2.3 

18.1 
9.0 
19.2 
12.8 
22.4 

2.0 

7.7 
18.4 
16.8 
18.5 

50.5 
11.6 
25.5 
16.4 
3.0 

6.7 

8.6 

30.2 

51.7 

3.1 

88.3 
2.7 
2.1 

12.0 

7  8 

Alger 

7  3 

Al  egan 

7  5 

Alpena 

3  8 

Antrim 

4   9 

Arenac 

2   7 

Baraga 

5  5 

Barry 

5  7 

Bay 

2  6 

Benzie 

6  6 

Berrien 

4  9 

Branch 

5  9 

Calhoun . . 

7  6 

Cass 

4  7 

Charlevoix 

7  2 

Cheboygan ,- 

7   1 

Chippewa 

7  6 

Clare 

3  7 

Clinton 

3  7 

Crawford 

6  6 

Delta 

6  7 

Dickinson ... 

4  6 

Eaton 

6.1 

Emmet 

7  4 

Genesee 

4  2 

Gladwin 

2  6 

Gogebic 

3  8 

Grand  Traverse 

8  3 

Gratiot 

5  7 

Hillsdale 

6  3 

6  5 

Huron 

3  3 

5  4 

Ionia 

4  8 

3  0 

5  5 

Isabella 

3  7 

5  9 

Kalamazoo 

9  8 

Kalkaska 

4  0 

6  1 

Keweenaw 

5  3 

4  2 

Lapeer 

4  4 

•Average  number  of  admissions  per  year  for  the  ten  year  period  ending  June  30,  1912. 
tRate  per  10,000  of  population. 


117 


TABLE  8.— Concluded. 


County. 


2t 


Leelanau 

Lenawee 

Livingston.  .  . 

Luce 

Mackinac. .  . . 

Macomb 

Manistee.  .  .  . 
Marquette.  .  . 

Mason 

Mecosta 

Menominee.  . 

Midland 

Missaukee.  .  . 

Monroe 

Montcalm .  .  . 

Montmorency 
Muskegon . . . . 
Newaygo .  .  .  . 

Oakland 

Oceana 

Ogemaw 

Ontonagon . . . 

Osceola 

Oscoda 

Otsego 

Ottawa 

Presque  Isle . . 
Roscommon. . 

Saginaw 

Sanilac 

Schoolcraft : . . 
Shiawassee.  . . 

St.  Clair 

St.  Joseph 

Tuscola 

Van  Buren . . . 
Washtenaw.  . 

Wayne 

Wexford 


5.9 

5.6 

17.1 

3.5 

7.2 

3.8 

5.5 

15.7 

6.9 

8.1 

11.2 

3.4 

13.8 

5.1 

29.4 

6.7 

9.8 

4.8 

9.7 

4.8 

15.5 

5.8 

6.9 

4.8 

4.1 

4.1 

12.2 

3.7 

14.9 

4.5 

.9 

2.5 

18.5 

4.7 

5.7 

2.7 

39.7 

8.4 

10.1 

5.7 

2.4 

2.8 

7.3 

9.9 

8.3 

4.6 

.9 

5.1 

2.6 

4.0 

22.7 

5.3 

2.6 

2.5 

1.0 

4.9 

38.6 

4.5 

11.5 

3.3 

7.7 

9.2 

15.0 

4.4 

21.6 

4.0 

14.3 

5.7 

11.1 

3.1 

25.1 

7.5 

32.1 

6.9 

218.8 

4.9 

10.3 

5.4 

♦Average  number  of  admissions  per  year  for  the  ten  year  period  ending  June  30,  1912. 
tRate  per  10,000  of  population. 


118 


TABLE  9. — Place  of  residence  before  admission  to  Michigan  State  Hospitals.     Admis- 
sions for  year  ending  August  31,  1914. 


to 

S   fro 

From  cities  of — 

Group  of  insanity. 

§ 

o 

1 

O 

o 
o_ 

00 
1 

o 
d 

05 

© 
1 

o 
o 
o 
in 

05 

o 

§ 

05 
05 

o 

If 

r 

1 

i 

c 

B 

•3 
o 

Manic  depressive 

79 
24 
25 
46 
96 

57 

8 

36 

5 

12 
11 
15 
29 

7 

54 
11 

5 
30 
42 

19 
8 

37 
3 

6 
13 
14 
11 

5 

20 
8 
11 
25 
19 

24 

4 

20 

6 
10 

4 
4 
1 

28 

9 

6 

16 

11 

2 

1 

18 

2 

4 
3 

7 
2 
1 

32 

5 

4 

25 

17 

11 
3 

23 
5 

2 
6 
6 
3 
1 

32 
11 
6 
14 
11 

12 
2 

27 
4 

fl 

5 

9 

12 

4 

1 

83 
13 
10 
34 
18 

14 
1 

43 
4 

4 
15 
10 
10 

2 

57 
2 
6 

22 

7 

5 

2 

34 

7 

7 

8 

16 

12 

2 

11 

1 
2 
8 
8 

6 
1 

11 

""2 
5 
2 

1 

396 

Psycho-neurotic 

84 

Paranoid . 

75 

Dementia  praecox . 

220 

Cerebro-syphilis 

Alcoholic 

229 
150 

Drug 

30 

Senile  dementia 

249 

Oreanic .  . 

30 

Infection,  exhaustion   and 

other  physical 

Defective 

46 

77 

Epileptic 

89 

Unclassified 

77 

Not  insane.  .  .  . 

21 

Total 

450 

258 

156 

110 

143 

150 

261 

187 

58 

1   773 

TABLE  10. — (Diagram  VII.) — Sex  in  relation  to  certain  forms  of  insanity.  Admissions 
to  Michigan  State  Hospitals  July  1,1906,  to  June  30,  1912,  and  September  1,1913,  to 
August  31,  1914. 


Males. 


Females. 


Totals. 


Manic  depressive. 
Dementia  praecox 
Cerebral  syphilis . 
Senile  dementia .  . 
Alcohol  and  drug. 


851 
925 
766 
561 
.589 


1,178 

620 

194 

349 

90 


2,029 

1,545 

960 

910 

679 


TABLE  11. — (Diagram  VI.) — Place  of  residence  before  admission  to  Michigan  State  Hospi- 
tals, given  by  percentages  for  the  principal  forms  of  insanity.  Based  on  admissions  for  the 
year  ending  August  31,  1914. 


Forms  of  insanity. 

Cities 

over 

100,000. 

10,000- 
50,000. 

5,000'- 
10,000. 

2,000- 
5,000. 

Less  than 
2.000. 

Residence 
unknown. 

Cerebral  syphilis 

% 

41.9 

36.11 

20.9 

15.66 

20.00 

14.5 

% 

26.6 

30.55 

25.00 

24.70 

18.7 

23.0 

% 

4.8 

1.67 

7.3 

6.02 

7.0 

6.9 

% 

7.4 
7.78 
11.4 
7.23 
8.1 
9.3 

% 

15.7 

19.99 

31.8 

42.17 

43.5 

41.9 

3  5 

Alcohol  am  drug 

3  89 

Dementia  praecox 

Epileptic  and  defective 

Manic  depressive 

3.7 
4.21 
2  8 

Senile  dementia 

4.4 

119 


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TABLE  13. — (Diagram  IX.) — Extent  of  use  of  alcohol  by  male  patients  admitted  to  Michigan 
State  Hospitals  Sept.  1,  191 S  to  Augmt  31,  1914. 


Per  cent. 


Occasional  moderate  use  of  alcohol 

Steady  moderate  u.se  of  alcohol 

Occasional  excessive  use  of  alcohol 

Steady  excessive  use  of  alcohol 

Steady  moderate  and  occasional  excessive  use  of  alcohol 

No  use  of  alcohol 

Facts  unknown .  .* 


23.8 
7.0 
9.7 

18.3 
3.2 

25.7 

12.2 


99.9 


TABLE  14. — Restdts  of  Wassermann  tests  on  patients  admitted  to  Michigan  State  Hos- 
pitals, September  1,  1913,  to  Aitgust  31,  1914. 


Number  of  individuals  whose  Wassermann  reaction  was — 


Males. 


Females. 


Totals. 


Positive. . . . 
Questionable 
Negative.  .  . 
Unobtained . 

Total .  . 


203 

34 

703 

82 


1,022 


77 

39 

490 

145 


751 


280 

73 

1,193 

227 


1,773 


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00  CO  01  CO  !>.  00 

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—  C1C3  C4 


ddClC4* 


00 


.  'vt'iA     1 


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a 


122 

TABLE  16. — Showing  occupation  in  relaiion  to  2,991  admissions  to  Michigan  State  Hospitals 

for  the  Insane. 


Total. 


Males. 


Females. 


Totals. 


Professional 

Clerical  and  oflBcial 

Mercantile  and  trading 

Public  entertainment 

Personal  service,  police  and  military 

Laborer  and  servant 

Manufacturing  and  mechanical  industry . . . 
Agricultural,  transportation,  other  outdoor 

Home  housekeeping 

None 

Unascertained 

Total 


72 
79 
102 
25 
29 

392 

224 

591 

0 

81 

67 


69 
37 
27 
4 
42 

129 
51 
155 
523 
227 

65 


141 

116 

129 

29 

71 

521 
275 
746 
523 
308 

132 


1,662 


1,329 


2,991 


123 


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12.7 
15.08 
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124 

TABLE  IS.— (Diagra^n  III.) 

DISCHARGED  CASES: 

Au  investigation  was  made    of  the  fate  of  983  cases  who  were  discharged   from  the  four  State 
Hospitals  during  the  biennial  period  ending  June  30,  1904. 

Satisfactory  information  was  obtained  concerning  329  males  and  338  females,  a  total  of  667  cases. 

CONDITION  WHEN  DISCHARGED: 

219  or  32.8%  recovered. 
350  or  52.5%  improved. 

80  or  12.1%  unimproved. 

18  or    2.7%  with  no  data. 

PREVIOUS  ADMISSIONS: 

A  total  of  134  cases  or  20%  had  had  previous  admissions  to  the  hospital  from  which  they  were 
discharged : 

85  with  1  previous  admission, 

28  with  2  previous  admissions, 
1 1  with  3  previous  admissions, 

4  with  4  previous  admissions, 
3  with  5  previous  admissions, 
3  with  6  previous  admissions. 

A  total  of  45  cases  had  had  previous  admissions  to  some  other  public  or  private  hospital. 

39  with  1  previous  admission, 

5  with  2  previous  admissions, 
1  with  3  previous  admissions. 

DURATIONS  OF  PRESENT  ADMISSIONS: 

113  with   9  weeks  or  under. 
231  with  10  to  24  weeks. 
162  with  25  to  49  weeks. 

54  with  50  to  74  weeks. 

29  with  75  to  99  weeks. 

26  with  100  to  149  weeks. 

15  with  150  to  199  weeks. 
12  with  200  to  299  weeks. 

16  with  300  to  399  weeks. 
6  with  400  to  499  weeks. 
1  with  700  weeks. 

1  with  800  weeks. 
1  with  900  weeks. 

READMISSIONS: 

There  was  a  total  of  317  individuals  or  47.5%  who  were  readmitted  to  the  hospital  from  which 
they  were  discharged  in  the  period  1902  to  1904.     Of  these: 

224  had    1  readmlssion, 
66  had    2  readmissions, 
15  had    3  readmissions, 
10  had    4  readmissions, 

1  had    5  readmissions, 

1  had  12  readmissions. 

The  periods  between  the  discharges  of  the  317  cases  and  their  first  subsequent  admissions  have 
been  as  follows: 

27  with  9  weeks  or  under, 
20  with  10  to  24  weeks, 
46  with  25  to  49  weeks, 
42  with  50  to  74  weeks, 
18  w.th  75  to  99  weeks. 
38  with  100  to  149  weeks, 
33  with  150  to  199  weeks, 
45  with  200  to  299  weeks, 
24  with  300  to  399  weeks, 

14  with  400  to  499  weeks,  , 

7  with  .500  to  599  weeks, 

1  with  600  to  699  weeks. 

2  with  unknown  duration. 

SUBSEQUENT  ATTACKS: 

There  was  a  total  of  56  individuals  or  8.4%  of  the  whole  number  under  consideration  who  had  had 
subsequent  attacks  of  their  mental  troubles,  which  were  not  taken  care  of  by  the  state  institutions. 

22  individuals  had  1  subsequent  attack. 

2  individuals  had  2  subsequent  attacks. 

3  individuals  had  3  subsequent  attacks. 

29  individuals  had  an  undetermined  number  of  attacks.     Of  these,  there  were: 

9  taken  care  of  in  some  other  institution, 
37  were  taken  care  of  in  the  home,  4  of  whom  were  also  taken  to  another  institution  either 
during  a  part  of  the  attack  or  during  another  attack. 


I 


125 

TABLE  IS.—Conclvded. 

PRESENT  CONDITION: 

Of  the  total  667  cases  it  was  found  that  391  or  58.6%  are  living  now;  185  or  27.7%  have  died. 
In  91  cases  or  13.6%  we  were  unable  to  ascertain  whether  they  were  living  or  dead,  however,  there 
were  some  facts  in  regard  either  to  previous  or  subsequent  admissions. 

OF  THOSE  LIVING: 

There  are  129  or  32.9%  who  are  living  in  the  .state  institutions  from  which  they  were  discharged- 

10  who  are  living  in  some  other  institution. 

2  whose  place  of  residence  was  uncertain. 

250  or  63.9%  who  are  living  outside  of  institutions. 

Of  the  total  262  individuals  who  are  not  living  in  the  state  institutions,  it  was  found  that  60  or 
22.9%  are  not  normal.  These  included  27  who  are  definitely  insane,  20  aberrated,  about  whom  the 
information  was  not  sufficiently  definite  to  call  insane,  bijt  did  point  to  a  condition  at  present  which 
could  not  be  called  normal — and  13  who  were  diagnosed  as  defective.  Of  this  same  262  individuals 
not  back  in  the  institution  about  25  or  9.5%  the  information  gathered  was  not  sufficient  to  enable 
us  to  make  a  judgment  in  regard  to  their  mental  condition.  However,  we  do  know  that  of  these 
25  cases  of  questionable  mental  condition,  9  or  36%  had  had  readmissions. 

6  had  had  1  readmission, 
2  had  had  2  readmissions, 
1  had  had  4  readmissions, 

and  2  of  the  number  had  had  subsequent  attacks,  which  were  not  cared  for  in  the  state  institution. 
Of  this  total  262,  who  are  not  living  in  the  state  institution,  177  or  67.5%  are  normal  at  present, 
in  so  far  as  could  be  judged  from  the  correspondence  in  regard  to  them.  Of  these  177  normal  patients 
out, 

85  or  48%  were  discharged  recovered, 

84  or  47.4%  were  discharged  improved, 

8  or    4.5%  were  discharged  unimproved. 

However,  38  or  21.4%  of  these  normals  had  had  subsequent  admissions  to  the  institution: 

27  with  1  readmission, 

9  with  2  readmissions, 
1  with  3  readmissions, 
1  with  4  readmissions, 

and  25  of  these  normals  had  had  subsequent  attacks  not  cared  for  by  the  institution. 

THOSE  DEAD: 

Of  the  total  number  of  667  cases,  185  or  27.7%  have  died  in  the  10  year  period  subsequent  to 
their  discharge  from  the  institution,  in  the  period  between  1902  and  1904.  Of  this  number  63  or 
34%  died  during  a  subsequent  admission  to  the  State  Hospital.  Nine  cases  died  in  some  other 
institution;  37  died,  but  the  place  of  their  death  was  not  ascertained,  while  76  or  41%  died  at  home. 

Of  the  122  who  did  not  die  in  the  state  institution: 

31  died  insane, 
1  died  aberrated, 
4  died  defective, 

making  a  total  of  36  individuals  or  29.5%  of  those  dead  who  were  not  normal.  In  67  or  54.9%  of 
the  122  deaths  it  was  impossible  to  determine  the  mental  condition.  However,  it  is  known  that 
10  of  this  number  had  one  subsequent  admission  to  the  State  Hospital  and  3  had  subsequent  attacks 
not  cared  for  in  the  institution.  Of  the  total  number  of  122  deaths  outside  the  institution,  19  or 
15.5%  were  normal  at  the  time  of  death. 

Of  these  19  normal: 

7  were  discharged  recovered, 

8  were  discharged  improved, 

4  were  discharged  unimproved, 

And  of  this  number  two  had  had  two  subsequent  admissions,  one  had  had  one  subsequent  attack 
not  cared  for  in  the  institution. 

The  period  of  years  intervening  between  the  discharge  of  this  normal  group  and  their  death  varied 
as  follows: 

1  for  whom  the  period  was  unknown, 

1  died  within  one  week  of  discharge, 

2  died  within  one  month  of  discharge, 
2  died  within  six  months  of  discharge, 

1  died  within  three  years  of  discharge, 

2  died  within  five  years  of  discharge, 

10  died  between  5  and  10  years  after  discharge. 

There  were  22  cases  or  11.8%  of  the  total  who  had  died  who  had  committed  suicide. 
This  number  of  22  were  discharged  as  follows: 

2  unknown, 
•   6  discharged  recovered, 

9  discharged  improved, 

5  discharged  unimproved. 


126 

TABLE  lS.~Continued. 

As  was  stated  above  in  91  or  13.6%  of  the  cases  it  was  impossible  to  determine  their  pres- 
ent condition.  However,  of  this  number  a  total  of  44  or  48.3%  had  had  admissions  previous  to 
the  one  terminated  in  the  period  under  consideration,  and  46  or  50.5%  had  had  subsequent 
admissions. 

29  with  1  subsequent  admission, 
13  with  2  subsequent  admissions, 

2  with  3  subsequent  admissions, 

2  with  4  subsequent  admissions. 

And  one  had  had  one  subsequent  attack  cared  for  outside  the  institution. 


TABLE  19. — Lansing  Industrial  School. 
RESULTS  OF  BINET  TESTS. 


Chronological  age 

Mental  age  of  inmates. 

of  inmates. 

15 

15 

14 

13 

12           11 

10    - 

9 

8 

7 

6 

Total 

17 

1 

18 

32             26 

1 

19 

1 

97 

16 ." 

1 

1 

30 

64 

66 

29 

10 

1 

2 

204 

1.5 

1 

13 

62 

75 

31 

9 

4 

195 

14 

4 

28 

58 

32 

16 

6 

1 

145 

13 

, 

12 

37 

29 

7 
4 

1 

86 

12 

j 

2 

19 

21 

1 

47 

I i 

11 

1 

6 

6 

7 

2 

1 

23 

i 

10 

i 

1 

1 

2 

4 

. 

Total 

2 

2 

65 

201 

288 

168 

56 

15 

3 

1 

801* 

•There  were  seven  boys  who  could  not  be  adequately  tested,  four  because  of  difficulties  in  understanding  or  expressing 
themselves  in  English,  one  because  of  blindness,  and  one  because  of  extreme  deafness.  There  was  one  other  boy  testing  12, 
but  whose  chronological  age  was  unknown. 


127 


TABLE  20.— Adrian  Industrial  School. 
RESULTS  OF  BINET  TESTS. 


Mental  age  of  inmates. 

Chronological  age  of 
inmates. 

14 

13 

12 

11 

10 

9 

8 

7 

6 

5 

4 

Total. 

20                                

1 

1 

1 

t 

10                      

1 

1 

7 

4 

1 

4 

18 

IS 

1 

12 

16 

8 

2 

4 

43 

17 

8 

29 

27 

17 

10 

2 

.    1 

94 

• 

16                                    

10 

31 

40 

22 

5 

4 

1 

1 

114 

13               

• 

4 

12 

17 

22 

5 

1 

61 

14 

4 

9 

2 

S 

4 

1 

25 

13  

1 

6 

7 

2 

2 

1 

19 

12 

1 

1 

2 

2 

2 

1 
..i 

8 

1 

11 

■     ■     ■! ■ 

1 

1 

2 

1 

10 

1 

i 

1 

1 

i 

Total 

1 

24 

97 

120 

82 

36 

20 

4 

0 

1 

1 

386 

Note  on  Tables  19  and  20. 

The  column  at  the  left  of  the  chart  gives  the  chronological  or  physical  age  of  the  individual  tested, 
while  reading  from  left  to  right  are  given  the  mental  ages  to  which  they  tested  according  to  the  Bmet 
Test  Scale.  The  column  at  the  right  of  the  chart  gives  the  total  number  of  inmates  of  any  given  age. 
Thus  in  Table  20  of  the  nineteen  year  old  girls  there  was  one  who  tested  14,  one  13,  seven  12,  etc., 
while  the  total  number  of  girls  nineteen  years  old  was  18. 

The  heavy  black  line  separates  the  inmates  into  two  groups.  To  the  right  of  the  line  appear  all 
cases  classed  as  feebleminded.  (Adrian  131  or  34%;  Lansing  171  or  21i%.)  To  the  left  of  the  hue 
appear  all  cases  classed  as  normal.     (Adrian  254  or  66%;  Lansing  630  or  781%). 

The  basis  on  which  this  classification  is  made  is  the  most  conservative.  Only  those  individuals 
whose  mental  age  was  four  or  more  years  less  than  their  physical  age  were  considered  feebleminded. 
Further  than  this  all  cases  which  tested  eleven  or  over  mentally,  were  classed  as  normal,  even  though 
they  were  four  or  more  years  retarded.  This  latter  policy  was  considered  as  the  only  safe  one — since 
the  Binet  Scale  is  quite  generally  considered  inadequate  for  those  individuals  whose  mental  develop- 
ment Is  eleven  or  more  years. 


128 

TABLE  21. — Adrian  and  Lansing  Industrial  Schools. 
SCHOOL  RECORD. 


Age  on  leaving. 


8  years . . 

10  years. . 

1 1  years . . 

12  years. . 

13  years. . 

14  years. . 

15  years. . 

16  years. . 
Unknown . 


Total . 


Grade  on  leaving. 


1st 

2nd 

3rd 

4th 

5th 

6th 

7th 

8th 

9th 

10th 

Ungraded  room . 
Unknown 


Total . 


Kind  of  school. 


Private 

Public — city 

Public — rural 

Parochial 

Public  city — public  rural . 
Public  city — parochial .  .  . 

Private — public  city 

Public  rural — parochial .  . 
Private — public  rural .  .  . . 
Unknown 


Total . 


Adrian. 


N. 


6 

3 

12 

21 

37 

23 

4 

2 


Kind  of  attendance. 

Regular 

Irregular 

Very  irregular 

Total 


108 


1 
1 

14 
8 
19 
26 
25 
12 
2 


108 


50 

37 
19 


106 


67 

11 

2 

20 

2 

3 


108 


Number  of  individuals  who  had  been  in  ungraded  rooms 


18 
18 
27 
59 
84 
51 
15 
5 


278 


7 
11 
27 
60 
67 
47 
38 
16 

3 


278 


87 

85 

102 


274 


5 

153 

47 

4 

51 

4 

9 

1 


278 


Lansing. 


1 
24 
21 
39 
80 
121 
74 
19 
7 


386 


X. 


53 
61 
78 
104 
77 
23 
4 
96 


14 
26 
36 
68 
68 
26 
1 
74 


496 


7 

13 

12 

27 

28 

54 

74 

90 

75 

108 

66 

80 

64 

60 

41 

35 

15 

7 

2 

1 

1 

3 

1 

18 

386 

496 

137 

97 

122 

129 

121 

253 

380 

479 

5 

220 

58 

6 
71 

6 
12 

1 


386 


3 

208 

14 

43 

84 

95 

7 

5 

I 

36 


496 


15 


313 


28 
31 
72 
69 
48 
30 
10 
1 


2 
22 


313 


25 

51 

214 


290 


104 
26 
29 
60 
60 
3 
1 


30 


313 


12 


¥ 


w 


129 


TABLE  22. — Adrian  and  Lansing  Industrial  Schools. 


Physical  facts. 

Adrian. 

Lansing. 

N. 

F. 

T. 

N. 

F. 

T. 

Teeth. 

14 
6 

20 
28 
16 
4 
21 
20 

54 

8 

14 

11 

15 

42 

101 

9 

30 

3 

13 

40 
24 
11 

34 
34 
15 
4 
V  28 
39 

74 
11 
17 
13 

26 

55 

130 

9 

43 
4 

17 

50 
30 

19 

37 
22 
38 
14 
12 
38 

169 
28 
21 
33 

50 

66 

114 

20 

48 
10 
10 

64 

77 
51 

41 
12 
24 
3 
10 
21 

117 
10 
18 
52 

33 

48 
92 
17 

31 
4 
5 

54 
61 
40 

78 

Widely  soaced 

34 

Poor                                                 

62 

17 

Temnorarv  teeth       

7 
19 

20 
3 
3 
2 

9 
13 
29 

22 

Kxoentionallv  cood                           

59 

Tonsils  or  Adenoids. 
P^nlare'pd  tonsils  or    adt*noids  nresent ....         

286 

Tonsi  3  or  adenoids  removed 

38 

Susnected    adenoids       .                         

39 

Month    breathers ....             

85 

Ears. 
Attached  lobules 

83 

Defeotive  helix  or  antihelix 

114 

Other  form  defect 

206 

Defertiv**  heariner                                                  

37 

Eyes. 

13 
1 
4 

10 
6 
8 

79 

Defective  vision  with  classes 

14 

16 

118 

Notahfv  undersized                      

128 

91 

17 


130 

TABLE  23. — Lansing  Industrial  School. 
EMPLOYMENT  HISTORY. 


Kinds  of  work. 


N. 


F. 


Number  of  individuals  who  had  been: 

Newsboys* .  .  .  .  , 

Bootblaclcs 

Delivery  boys 

Clerks 

Messengers 

Employed  in  show  places 

Employed  at  odd  jobs ; 

Farm  laborers 

Office  boys 

Factory  employees 

Number  of  mdividuals  who  had  no  employment 

Number  of  individuals  about  whom  employment  facts  were  unknown 

Total 


222 

108 

330 

29 

17 

46 

46 

15 

61 

25 

7 

32 

25 

13 

38 

21 

10 

31 

309 

151 

460 

144 

100 

244 

16 

2 

18 

78 

41 

119 

3 

2 

5 

7 

6 

13 

925 


472 


1,397 


Number  of  individuals  who  had  been  employed  in  the  following  number  of 
street  trades  :t 
One. 


Two.  . 
Three . 
Four. . 


194 

41 

3 


96 

19 

2 

1 


290 

-60 

5 

1 


Total . 


238 


118 


356 


Number  of  different  places  worked  in  by  each  individual. 


N. 

F. 

121 

106 

139 

87 

101 

46 

63 

20 

26 

12 

12 

1 

i 

3 

466 

272 

One  place . . . 
Two  places . 
Three  places 
Four  places . 
Five  places . 
Six  places . . . 
Seven  places 
Eight  places 

Total .  . 


227 

226 

147 

83 

38 

12 

2 

3 


738 


♦Including  those  who  either  sold  or  delivered  papers. 

tin  this  group  of  trades  have  been  included  newspaper  selling  or  delivering,  shoe  shining,  messenger 
service,  and  any  kind  of  employment  at  show  places. 


131 

TABLE  24. — Adrian  Industrial  School. 
ADRIAN  EMPLOYMENT  HISTORY. 


Kinds  of  work. 


N. 


Domestic 

Dishwasher 

Nurse  girl 

Chambermaid 

Waitress  in  hotel 

Waitress  in  restaurant. . . 
Cleric  in  5  and  10c  store. 
Clerk  in  other  stores .  . . . 

Telephone  girl 

Laundry  employees 

Factory  employees 

Odd  jobs 


46 
5 
5 
4 
5 
7 
4 
5 
6 


20 
5 


108 
17 
27 


22 

10 

6 

8 

4 

8 

50 

19 


154 

22 

32 

4 

27 

17 

10 

13 

9 

8 

70 

24 


Total . 


Ill 


279 


390 


Of  the  386  girls,  there  was  one  stenographer,  one  Western  Union  employee,  one  canvasser,  one 
prostitute,  one  dressmaker,  one  milliner,  one  oflBce  girl,  one  news  collector,  one  vaudeville  performer, 
one  hairdresser,  one  milk  wagon  driver,  and  six  cash  girls.     Total,  407. 


Number  of  different  places  worked  in  by  each  individual. 

N. 

F. 

T. 

One  Dlaoe . 

19 

17 

13 

6 

1 
6 
1 
2 

29 

30 

39 

31 

11 

10 

6 

1 

1 

1 

48 

Two  nlaces ...            

47 

Three  nlaces 

52 

Four  T)lares 

37 

Five  Dlaces ...                                  

12 

Six  Dlaces. ...                      

16 

Seven  nlaces 

7 

Nine  Diacea                                              

3 

1 

Eleven  nlaces .  .          

1 

Total ...                     . 

65 

159 

224 

Number  of  weeks  each  individual  remained  In  first  place  of  employment. 

18 
2 
4 
6 
3 
1 
2 
2 
1 

13 
9 
4 
4 

40 

18 

11 

13 

6 

8 

5 

13 

al 

14 
9 
4 

58 

Two  weeks ....                

20 

Three  weeks                                                      

15 

Four  weeks                                          

19 

9 

Six  weeks                                                                       

9 

7 

Kierht  w^eeks                                                                                      

16 

Nine  weeks                                                                        

4 

48 

Twentv  to  twentv-nine                                                           

23 

Thirtv  to  fortv-nine                                                         

13 

8 

Total                                                                             

69 

179 

268 

132 


TABLE  24:.— Adrian.— Concluded. 


Lowest  weekly  wage  received  by  each  individual. 

N. 

F. 

T. 

Less  than  $1 .00 

1 
4 

1 
9 
2 
7 

8 

10 

17 

10 

21 

8 

5 

5 

9 

$1.00  to    1.50 

14 

1.50  to    2.00 

18 

2.00  to    2.50 

19 

2.50  to    3.00 

23 

3.00  to    3.50 

15 

3.50  to    4.00 

5 

4.00  to    5.00 

1 

6 

5.00  to    6.00 

Over  $6.00 

2 

I 

3 

Total 

27 

85 

112 

Under  $1.00 

1 
3 
3 
5 
8 
6 
9 
4 
0 
2 
1 
3 

2 

13 

18 

10 

24 

24 

18 

10 

3 

3 

2 

1 

3 

$1.00  to  $2.00 

16 

2.00  to    2.50 

21 

2.50  to    3.00 

15 

3.00  to    4.00 

32 

4.00  to    5.00 

30 

5.00  to    6.00 

27 

6.00  to    7.00 

14 

7.00  to    8.00 

3 

8.00  to    9.00 

5 

9.00  to  10.00 

3 

Over  $10.00 

4 

Total 

45 

128 

173 

133 


TABLE  25. — Adrian  and  Lansing  Industrial  Schools. 
DELINQUENT  RECORD. 


Character  of  first  offense.* 

Adrian. 

Lansing. 

N. 

F. 

T. 

N. 

F. 

T. 

Arson 

3 

1 

8' 

Q 

Assault 

1 

Attempt  to  kill 

1 
14 

J 

Burglary 

22 

Delinquent 

1 

1 

26 

12 

2 

2 

2 

1 

2 

32 

17 

2 

3 

3 

1 

Dependent 

Disobedient 

8 

24 

3 

1 

1 

15 

1 

9 
39 

Disorderly 

Drunkenness 

i 

1 

Forgery 

1 

Fraudulent  buying 

Hopping  trains 

2 

3 

3 

229 

2 

1 

1 

126 

4 

Incorrigible 

Indecent  language 



8 

19 

1 

23 

6 

1 

27 

1 

36 

6 
1 

4 
4 

Larceny 

12 

SBH 

Larceny  and  sex 

Malicious  destruction  of  property 

3 

13 

3 

154 

8 

10 

2 

17 

2 

100 

11 

8 

5 

Neglected  and  dependent 

30 

Sex 

34 
30 

94 

56 
4 

128 

86 
4 

.1; 

254 

Truant  and  disorderly 

19 

18 

Truant  and  sex 

15 
11 

15 
19 

Unmanageable 

8 

1 

1 

15 

2 

■  "12 

3 

Violation  of  pure  food  law 

1 

2 

2 

4 

27 

108 

278 

386 

496 

313 

809 

T^rpatrnprit  for  fir^f  nfTpnQP 

Adrian. 

Lansing. 

N. 

F. 

T. 

N. 

F. 

T. 

Industrial  School 

45 

135 

180 

"1 

1 

6 

39 

22 

75 

j- 

2 
17 
21 

186 

1 

Correctionary  Institution  (outside  of  state) 

2 

Jail 

Detention  Home 

4 
25 

7 
42 

li 

8 
56 

Ford  Republic 

43 

Salvation  Army 

2 
4 

^       2 
6 

State  Public  School 

2 

4 

1 

22 

8 
1 
4 

12 

Other  State  Charitable  or  Educational  Institution .... 

2 

Private  Orphan  Asylum 

7 
1 
14 
8 
2 

25 
1 

27 
28 

7 

32 

2 

41 

36 

9 

26 

County  Infirmary 

Number  of  individuals  who  were  dismissed 

Number  of  Individuals  whose  treatment  was  unknown. . . 

i69 
94 
26 

87 
68 
29 

256 

162 

55 

108 

278 

386 

496 

313 

809 

*By  "  First  Offense"  is  meant  the  first  delinquency  which  brought  the  individual  in  actual  conflict 
with  the  law. 


134 


TABLE  25. — Adrian  and  Lansing, 

— Continued. 

Adrian. 

Lansing. 

N. 

F. 

T. 

N. 

F. 

T. 

Number  of  times  individuals  were  placed  on  probation. 
One  time 

11 
2 
1 

18 
6 
3 
2 
1 

29 
8 
4 
2 
3 

86 
37 
15 
5 
1 
1 
1 
2 
1 
1 

43 
16 

15 

1 
1 

1 

129 

Two  times 

52 

Three  times 

30 

Four  times 

6 

Five  times 

2 

2 

Six  times 

2 

Seven  times 

1 

Eight  times 

2 

Ten  times 

1 

Unknown  times 

1 

Total 

16 

30 

46 

150 

76 

226 

Dismissal  Record. 

Number  of  times  individuals  were  dismissed: 

One  time 

1 

1 

21 
9 
3 

20 

7 
3 

41 

Two  times 

16 

Three  times 

6 

Total 

1 

1 

33 

30 

63 

Number  of  Delinquencies. 
Number  of  individuals  with: 

67 
26 
23 
2 
2 
1 
1 

167 

78 

4 

6 

2 

234 

104 

27 

8 
4 

1 
1 

127 

161 

104 

51 

24 

11 

1 

5 

2 

80 
103 
68 
34 
14 
3 

j- 

4" 

■      6' 

207 

Two 

264 

172 

Four 

85 

Five 

38 

Six 

14 

1 

Eight 

6 

1 

1 

2 

Ten 

4 

Eleven 

3 

7 

3 

Unknown 

4 

2 

6 

13 

Total 

127 

259 

386 

496 

313 

809 

135 


TABLE  25. — Adrian  and  Lansing. — Concluded. 


Causes  of  Commitment. 

Adrian. 

Lansing. 

N. 

F. 

T. 

N. 

F. 

T. 

Number  of  individuals  committed  for: 

1 

1 

2 

2 

3 

16 

1 
8 

3 

7 
14 

5 

Assault 

10 

Burclarv .  .             

29 

Foreerv .        

1 

Grand  larcenv 

16 

Immoralitv       

34 
11 
14 

117 
16 
32 

151 
27 
46 

Immoral  t>  us  other  offenses* 

Tjarcenv                                     

281 

7 

66 
84 
26 

4 

149 
4 
3 

72 

31 

21 

2 

430 

TVf  alioinim  dpstmrtion  of  Drooertv       

11 

Neelected  and  deoendent 

4 

24 

29 

1 

1 

6 

49 

69 

1 

3 

10 

73 

98 
2 

4 

3 

Truant                      

138 

Truant  and  disorderly 

115 

Other  causes 

46 

Cause  unknown 

6 

♦Total 

108 

278 

386 

496 

313 

809 

♦Total  for  Adrian  does  not   include  the  figures  for   the  "Immoral  plus  other  offenses"    as  these 
numbers  have  already  been  included  under  the  different  offenses  such  as  larceny,  truancy,  etc. 

AGE  OF  COMMITMENT. 


Number  of  individuals  whose  age  was  the  following 

Adrian. 

Lansing. 

number  of  years. 

N. 

F. 

T. 

N. 

F. 

T. 

Ten              

4 
2 
8 
12 
19 
22 
30 
11 

6 
15 
16 
26 
51 
67 
71 
25 

1 

10 
17 
24 
38 
70 
89 
101 
36 
1 

32 
65 
86 
88 
09 
76 
47 

17 
24 
41 
65 
75 
66 
24 

49 

Eleven   

89 

Twelve                  .        

127 

Thirteen 

153 

Fourteen 

174 

Fifteen 

142 

Sixteen                      

71 

SftVf^ntftftn                                                         

Unknown 

3 

1 

4 

Total                

108 

278 

386 

496 

313 

809 

136 


TABLE  26. — Institutional  record  subsequent  to  first  offense.* 


Total  institutional  residencps 

Adrian 

Lansing 

N. 

F. 

T. 

N. 

F.     . 

T. 

Number  of  individuals  who  had  been  resident  in  the 
following  number  of  institutions: 
One 

20 

8 
1 

47 
13 

1 

67 

21 

2 

72 

42 

20 

2 

2 

2 

48 

14 

2 

120 
^6 

Two 

Three 

22 

Four 

2 

Five 

2 

2 

9 

Six 

2 

Total 

31 

61 

92 

140 

64 

204 

Correctionary  institutional  residences. 

Number  of  individuals  who  had  been  resident  in  the 
following  number  of  correctionary  institutions: 

One .-. 

Two 

Three 

20 
3 

39 
6 
1 

59 
9 
1 
1 

74 

33 

10 

2 

2 

2 

45 

12 

2 

119 
45 
12 

Four 

Five 

1 

2 
2 

Six 

2 

Total 

24 

46 

70 

123 

59 

182 

Number  of  individuals   who  had  been   resident  in   the 

One 

Three 

8 
3 

1 

10 
2 
3 

18 
5 
4 

22 

7 

1 

7 

29 

7 
1 

Total 

12 

15 

27 

30 

7 

37 

DISTRIBUTION  OF  CORRECTIONARY  INSTITUTIONAL  RESIDENCES. 


Adrian. 

Lansing. 

N. 

F. 

T. 

N. 

F. 

T. 

Number  of  individuals  who  had  been  in  the  Ford 
Republic: 
One  time 

15 
1 
1 
2 

1 

16 

Two  times 

1 

Three  times 

1 

Five  times 

2 

1 

Total . 

19 

1 

20 

*Does  not  include  the  present  residence  at  the  State  Industrial  School. 


137 


TABLE  2Q.— Concluded. 


Adrian. 

Lansing. 

N. 

F. 

T. 

N. 

F. 

T. 

Number  of  individuals  who  had  been  in  jail: 

2 

2 

4 

9 
1 

4 

13 

Four  times       .                           

1 

Total 

2 

2 

4 

10 

4 

14 

Number  of   Individuals  who  had   been  in   the   State 
Industrial  School: 
One  -time                             

1 

1 

25 

12 

1 

37 

Two  times       

1 

Three  times                                                

2 

2 

Total .      .              

1 

1 

27 

13 

40 

Number  of  individuals  who  had  been  in  a  detention 
home: 
One  time                             

18 
3 

37 
6 

1 

65 
5 
1 

1 

52 
11 

36 
1 

88 

Two  times             

12 

Four  times                                           

1 

1 

1 

22 

44 

66 

64 

37 

101 

Number  of  individuals  who  had  been  in  other  correc- 
tionary  institutions: 

4 

4 

DISTRIBUTION     OF     NON-CORRECTIONARY     INSTITUTIONAL     RESIDENCES. 


Adrian. 

I 

.ansing. 

N. 

F. 

T. 

N. 

F. 

T. 

Number  of  individuals  who  had  been  in  the  State  Public 
School : 
Once     .             

1 

3 
3 

4 
3 

1 

1 

Twripp                                                                    

Total .  .              

1 

6 

7 

1 

1 

Number  of  individuals  who  had  been  in  other  State 
charitable  or  educational  institutions: 

1 

2 

3 

Number  of  individuals  who  had  been  in  private  orphan 
asylums: 

7 
3 
1 

8 
2 

15 
5 
1 

18 
5 

1 

4 

22 

Twice                                     

5 

1 

Total                                     

11 

10 

21 

24 

4 

28 

Number  of  individuals  who  had  been  in  county  infirm- 
aries : 

Oti^p                                                              

2 

2 

4 

1 

5 

138 


TABLE  27. — Lansing  Industrial  School. 
HABITS. 


Sex  habits.* 

N. 

F. 

T. 

Number  of  individuals  who  had  practiced: 

Sodomy 

35 
93 

53 

21 

8 

19 

26 

9 

102 

110 

24 
60 

32 

16 

6 

7 

23 

8 

61 

64 

59 

Masturbation 

153 

Number  of  individuals  who  had  had  sexual  intercourse 

85 

1  to  3  times 

37 

4  to  10  times 

14 

Over  10  timest r. . . 

26 

Number  of  individuals  who  had  practiced: 

Sodomy  and  masturbation 

49 

Sodomy,  masturbation,  and  had  had  sexual  intercourse 

17 

Either  sodomy,  masturbation,  or  both 

163 

One  or  more  of  the  sex  habits 

174 

Use  of  tobacco. 

Number  of  individuals  who  had: 

Smoked 

354 
65 

154 
25 

227 

48 

123 

5 

581 

Smoked  excessively 

113 

277 

Chewed  since  coming  to  the  Institution 

30 

Use  of  alcohol. 

Number  of  individuals  who  had  been  drunk  the  following  number  of  times: 
One 

32 
9 
1 
3 
7 
117 

25 

13 

3 

3 

9 

51 

57 

Two 

22 

4 

Four 

6 

16 

Number  of  individuals,  the  extent  of  whose  drinking  is  unknown 

168 

Total 

169 

104 

273 

♦Total  cases  considered 

Total  normal  cases  considered 

Total  feebleminded  cases  considered . 


229 
147 

82 


Adrian  Industrial  School. 


N. 

F. 

T. 

Number  of  individuals  who  had  had  intercourse  with  the  following  number  of 
men: 
One 

13 
17 
14 
5 
5 
2 
3 
2 
7 

39 
36 
31 
11 

8 
10 

8 
22 
31 

52 

Two 

52 

Three 

45 

Four 

16 

Five 

13 

Six 

12 

Seven  to  nine 

11 

Over  ten 

24 

Unknown  number 

38 

Total 

68 

195 

263 

tincluding  those  who  had  had  intercourse  "a  great  many  times,"  exact  number  unknown. 


139 


TABLE  28. — Adrian  and  Lansing  Industrial  Schools. 
NATIVITY  OF  INMATES. 


- 

Adrian. 

Lansing. 

N. 

F. 

T. 

N. 

F. 

T. 

Place  of  birth  unknown 

7 

7 

14 

9 

9 
5 

4 
2 

18 

2 
8 

j- 

1 

3 
1 

27 

Austria-Hungary 

11 

Canada 

6 

16 

1 

22 
1 

13 

England — Wales 

4 

Finland .... 

3 

France 

1 

Germany 

1 

1 

1 
2 

5 
.. 

4 

8 

Holland 

1 

1 

Ireland 

1 

Italy 

1 

■■■i" 

1 
1 

5 

Norway 

German  Poland 

2 
11 

2 

2 

Russian  Poland 

20 
2 

31 

Russia 

1 

1 

2 

Scotland 

1 

Sweden 

1 
6 

1 

Other  countries 

8 

Total  foreign  born 

8 

21 

29 

59 

33 

92 

Michigan 

78 
2 

216 

4 
8 
2 
6 
4 

3 

7 

294 

6 
8 
2 
8 
6 

2 

5 

12 

356 

20 
11 

7 
11 

5 

4 

4 

10 

237 

5 
2 
4 
7 
3 

1 
2 
1 

593 

Illinois 

25 

13 

New  York 

11 

2 
2 

2 
2 
5 

18 

Pennsylvania 

8 

New  England  States 

5 

6 

Western  States 

11 

Total  native  born 

93 

2.50 

343 

428 

262 

690 

140 


TABLE  29. — Adrian  and  Lansing  Industrial  Schools. 
NATIVITY  OF  INMATES'   PARENTS.* 


Adrian. 

Lansing. 

N. 

r. 

T. 

N. 

F. 

T. 

Place  of  birth  unknown 

56 

1 

17 

5 

159 

4 

73 

6 

6 

1 

43 
5 

""2 
2 

3 
2 
5 
5 

215 

5 

90 

11 

6 

2 

56 
10 

1 
2 
4 
2 

4 
2 
8 
8 

222 

22 

63 

19 

8 

5 

89 

9 

16 

13 

2 

7 

127 

6 

3 

11 

1 
19 

179 

6 
32 
11 

2 
11 

55 
7 
3 

10 

"i4' 

99 

4' 

4 
""5 

401 

Austria  Hungary 

28 

Canada 

95 

England 

30 

Fimand 

10 

France 

1 

13 
6 

1 
2 
2 

16 

Germany 

Holland 

Ireland 

144 
16 
19 

Italy 

23 

Norway 

German  Poland 

2 
21 

Russian  Poland 

1 

226 

Russia 

6 

Scotland 

Sweden 

3 
3 

7 
15 

Switzerland 

1 

Other  countries 

4 

4 

24 

Total  foreign  born 

54 

161 

215 

420 

263 

683 

Indiana 

64 

3 

6 

10 

6 

4 

5 
1 
4 

3 

144 

1 
12 
15 
19 

9 

1 

5 

10 

20 

208 

4 
18 
25 
25 
13 

6 

6 

14 

23 

237 

8 
16 
18 
16 

4 

4 

14 
14 

19 

137 

2 

8 

4 

16 

8 

2 
4 
1 

2 

374 

10 

24 
22 

Ohio. 

32 

12 
6 

Southern  States 

18 

Western  States 

15 

21 

106 

234 

342 

350 

184 

534 

SUMMARY. 


Both  parents  foreign  born 

One  parent  foreign  born 

Both  parents  native  born 

One  parent  native  born,  one  unknown 
Both  parents  unknown 

Total ." . . 


Adriarv 


Lansing. 


N. 

F. 

T. 

N. 

F. 

T. 

15 

1 
56  ! 

71 

179 

114 

293 

24 

50   i 

74 

62 

36 

98 

37 

79 

116 

140 

70 

210 

13 

46   1 

59 

33 

22 

55 

19 

47 

i 

66 

82 

71 

153 

108 

278  1 

386 

496 

313 

809 

*Figur&s  include  nativity  for  both  the  fathers  and  mothers. 


141 


TABLE  30. — Adrian  and  Lansing  Industrial  Schools. 
RESIDENTIAL  HISTORY. 


Adrian. 

Lansing. 

N. 

F. 

T. 

N. 

F. 

T. 

Number  of  individuals  committed  from: 

Detroit 

Grand  Rapids 

27 
12 

20 

12 

8 

9 

4 

15 

45 
19 

42 
34 
39 

28 
7 

48 
9 

7 

72 
31 

62 

37 

11 

63 

9 

8 

154 
43 

71 
65 
62 
33 
23 
40 
19 
6 

95 
23 

43 
30 
27 
23 
22 
28 
12 
10 

249 
66 

Cities  from: 

24,000  to  51,000  inclusive 

10,000  to  18,000  inclusive 

114 
85 

5,000  to  9,999  inclusive 

79 

2,000  to  4,999  inclusive 

56 

1,000  to  1,999  inclusive •. 

45 

Less  than  1 ,000 

68 

Rural  districts 

31 

Place  unknown 

i 

16 

Total 

108 

278 

386 

496 

313 

809 

Number  of  individuals  who  had  lived  in  the  following 
number  of  cities  outside  of  Michigan: 

One 

Two 

26 
7 
3 
2 

47 
16 
7 
2 
3 
1 

73 

23 

10 

4 

3 

2 

99 

36 

26 

4 

3 

2 

64 

16 

6 

2 

153 

62 

Three 

Four 

Five 

31 
6 
3 

•    Six 

1 

2 

Seven 

1 

2 

324 

■■235' 

1 

Over  eight 

2 

69 

202 

271 

569 

Total. : 

108 

278 

386 

496 

313 

809 

Number  of  individuals  who  had  lived  in  the  following 
number  of  cities: 

One* 

Two , 

26 

28 

15 

19 

6 

5 

3 

2 

2 

2 

73 

75 

48 

34 

18 

15 

3 

2 

5 

5 

99 

103 

63 

63 

24 

20 

6 

4 

7 

7 

159 

118 

74 

67 

38 

14 

7 

4 

9 

16 

120 

64 

48 

28 

23 

9 

4 

3 

"i-i" 

279 
182 

Three 

Four 

Five 

Six 

Eight 

122 
85 
61 
23 
11 
7 
9 

Ujiknown 

30 

Total .^ 

108 

278 

386 

496 

313 

809 

Number  of  individuals  who  had  moved  the  following 
number  of  times: 
One 

12 

14 

16 

13 

13 

18 

9 

2 

2 

4 

5 

1 

27 
35 
55 
27 
35 
22 
14 
13 
13 

7 
14 

4 
12 

39 
49 
70 
40 
48 
40 
23 
15 
15 
11 
19 
5 
12 

72 

77 

80 

78 

60 

36 

18 

9 

10 

9 

8 

30 

20 

44 

54 

57 

43 

36 

11 

12 

2 

3 

1 

5 

23 

22 

116 

Two 

Three 

Four 

131 
137 
121 

Five 

86 

Six 

46 

Seven.                                                   

30 

Eight . .    . 

11 

Nine 

13 

10 

Over  ten ...                               

13 

53 

Number  of  individuals  who  had  never  moved 

42 

Total                                                 

108 

278 

386 

496 

313 

809 

*A  city  lived  in  at  different  periods  is  counted  as  a  separate  city. 


142 


TABLE  31. — Adrian  and  Lansing  Industrial  Schools. 
COUNTY  OF  COMMITMENT. 


NuitiliGr  of  in(iivifiii!).1ci  pnmmittpH  frrtm 

Adrian. 

Lansing. 

N. 

F. 

T. 

N. 

F. 

T. 

Alcona. 

1 
4 
7 
3 
2 

1 
2 
6 
2 
13 

3 
24 

""3 
5 
6 

4 

""3 

4 
4 
2 
3 
1 

7 

1 

Alger 

1 
2 

1 
1 

1 
2 

1 
1 

7 

Allegan 

12 

Alpena 

g 

Antrim 

2 

Baraga 

1 

Barry 

1 

1 
1 
3 

3 
2 

1 
10 

1 
3 

4 

3 

2 

13 

1 
6 

6 

Bay 

10 

Benzie 

2 

Berrien 

16 

Branch 

7 

Calhoun 

3 

28 

Cass 

2 

Charlevoix 

1 

5 
2 

2 
1 
1 
2 
3 

2 

7 

■■"i" 
4 

2 

6 
2 

3 
1 
5 
3 
6 

4 
11 

1 
1 
5 

2 

5 

1 

5 

g 

Cheboygan 

2 

Chippewa 

1 

12 

Clare 

Delta 

■4" 
1 
3 

2 
4 

1 

4 
2 
2 

3 
3 

""5 

4 

3 

11 

8' 

9 
1 
6 
4 
12 

16 

■■■44' 

1 
1 

4 
4 

4" 

4 

3 
1 
3 
2 
4 

2 
5 
3 

6 
2 

1 

3 
3 
1 
2 
3 

3' 
5 
3 
12 

1 

2' 
7 

11 

1 

24 

4* 

2 

1 
2 
5 
4 

5 
1 

'■'i' 

2 

4" 
3 

10 

Dickinson 

4 

Eaton 

3 

6. 

6 

Gladwin 

1 

2 

Grand  Traverse 

1 

g 

4 

Hillsdale 

6 

Houghton 

1 

8 
3 
3 

5 

""5 
5 

17 

1 

19 

9 
3 

7 

5 

1 

1 
7 
6 

25 

1 

31 

16 

Huron 

3 

Ingham 

4 

20 

Ionia 

10 

1 
1 
2 
1 

8 

1 

Iron 

6 

6 

Jackson 

19 

Kalamazoo 

27 

1 

Kent .N 

12 

68 

Keweenaw 

1 

Lake 

1 

5 
2 
2 
8 

7 

1 

1 

6 
2 
4 
9 
8 

4 

•     5 

Lapeer 

6 

Lenawee 

5 

Mackinac 

2 
1 
1 

3 

2 

Macomb 

g 

Manistee 

Marquette 

Mason ■ 

8 

8 
2 

Mecosta 

2 
2 
3 

2 
7 
6 

2 
2 

4 

3 

8 

7 

3 

Menominee 

3 

Midland 

1- 

1 
1 

1 

6 

Missaukee 

2 
g 

Montcalm 

6 

Muskegon 

1 

1 

4 

4 

g 

143 


TABLE  Zl.— Concluded. 


Number  of  individuals  committed  from 

Adrian. 

Lansing. 

N. 

F. 

T. 

N. 

F. 

T. 

Newaygo 

1 
1 

1 

3 

2 
4 

■■'io' 

1 
1 

1 

2 

2 
5 
2 

1 

2 

2 

Oalcland 

16 

Oceana 

3 

Ogemaw 

1 

2 
2 

3 

1 

3 
2 

4 
1 

2 

Ontonagon 

1 

Osceola 

1 

4 

Oscoda 

Otsego ■ 

1 
...... 

1 

Ottawa 

1 

1 

8 
2 

1 
5 
3 
1 

1 

5 
1 
1 
3 

7 

48 

6 

2 

9 
3 

1 

t 

1 
1 

7 
2 
1 
3 

10 

75 
7 
2 

5 
1 

5 

Presque  Isle 

4 

Roscommon 

Saginaw 

13 
3 
2 

1 

11 
2 
4 

4 

8 

161 

2 

3 

1 
2 
2 
4 

7 
2 
2 
2 

■■■99' 
"'2 

14 

Sanilac , 

5 

Schoolcrah 

4 

Shiawassee 

6 

St.  Clair 

2 

1 

18 

St.  Joseph 

4 

Tuscola 

6 

6 

3 

27 
1 

8 

Wayne 

260 

2 

Unknown 

5 

Total 

108 

278 

386 

496 

313 

809 

144 


TABLE  32. — Lansing  Industrial  School. 
PATERNAL  OCCUPATIONS. 


Skilled  work. 

N. 

F. 

T. 

Trade* 

68 
23 
19 
14 

8 

5 
4 
4 
4 
3 

3 
2 
2 

1 
1 

1 
1 

1 
1 

19 

13 

4 

7 

1 

1 

1 
1 
1 
5 

""2 

1 

87 

Carpenter 

36 

Painter 

23 

Railroad,  skilled 

21 

Store  owners 

9 

Tailor 

6 

Printer . .    . 

5 

Contractor 

5 

Clerk 

5 

Barber 

g 

Office 

3 

Traveling  man 

2 

Automobile 

2 

Insurance 

1 

Chauffeur 

2 

Minister 

1 

Real  estate 

1 

1 

Acrobat 

1 

2 

Jeweler 

1 

Total 

165 

57 

222 

Unskilled  work. 
Laborer 

89 
80 
15 
12 
5 

5 
1 
1 

1 
1 

67 

61 

4 

6 

16 

2 
2 
3 

""3 

156 

141 

Miner 

19 

18 

Lumberman 

21 

Section  hand 

7 

3 

Sailor 

4 

Waiter 

1 

Fisherman 

4 

Total 

210 

164 

374 

Work  unclassified  as  to  skill. 
Unknown  occupation 

81 

29 

2 

2 

2 
2 
2 
1 

55 
29 

7 

136 

Farmers 

58 

Bartenders . .    . . 

9 

2 

2 

Peddler 

3 

2 

Lighthouse  keeper 

1 

Total 

121 

92 

213 

♦The  following  were  classed  as  trades:  blacksmith,  bricklayer,  cement  worker,  chef,  cigar  maker, 
electrician,  harness  maker,  mason,  mill  wrlght,  plasterer,  plumber,  ship  builder,  shoemaker, 
stationary  engineer,  and  stone  cutter. 


145 

TABLE  33. — Lansing  Industrial  School. 
MATERNAL  OCCUPATIONS. 


N. 


Wage  earning  by  home  work. 
General  jobs  outside  of  home. 

Hotel 

Stores 

Cigar  factory 


Other  factories. 
Dressmaking. . . 

Nursing 

Boarding  house. 
Roomers 


67 
76 
11 

7 
8 

7 
7 
4 
6 
3 


Laundry 

Teacher 

Chief  telephone  operator 

Tailor 

Worke<l,  but  kind  unknown 

No  facts  signifying  that  they  worked . 


1 

1 

4 

290 


67 

48 

1 

2 

1 

9 
2 
1 


134 

124 

12 

9 

9 

16 
9 
5 
6 
3 

6 


180 


1 

1 

4 

470 


Total. 


496 


313 


809 


19 


146 

TABLE  34. — Adrian  and  Lansing  Industrial  Schooh. 
INSTITUTIONAL  RECORD  OF  RELATIVES. 


Adrian. 

Lansing. 

N. 

F. 

T. 

N. 

F. 

T. 

Number  of  parents  who  had  been  in : 

Adrian  Industrial  Home 

1 
1 

1 

1 

■  'io' 

5 
16 

1 
2 
3 

1 
8 

2 
1 

11 
5 

20 
2 
2 
4 
1 
8 

2 

2 

Lansing  Industrial  School 

State  Prisons 

5 
14 
60 
6 
2 
8 
1 
1 

2 
11 
46 

""2 
1 
1 

7 

House  of  Correction 

25 

Jail 

Correctionary  institutions  outside  of  Michigan 

State  charitable  or  educational  institutions* 

4 
1 

106 
6 
2 

Insane  hospitals 

State  Public  School 

'  1 

10 
2 

County  Infirmaries  ....;.             

2 

Number  of  fraternity  who  had  been  in: 

Adrian  Industrial  Hornet 

4 
3 

20 
37 

24 
40 

9 
51 
8 
8 
6 

7 
23 
5 
4 
3 

1 
19 

16 

47 

2 

5 

2 

4 
25 

2 
5 

1 
20 

25 

Lansing  Industrial  Schoolf 

98 

Ford  Republic 

10 

House  of  Good  Shepherd 

1 

2 

3 
10 

1 
3 
2 
2 

1 

1 
30 

3 
12 

14 
12 

7 
3 
3 

1 

3 

4 
12 

1 
3 
2 
3 

1 

2 
34 

3 
13 

14 

14 
8 
4 

7 

1 

3 

13 

State  prisons 

House  of  Correction 

8 
11 

Jail 

48 

Correctionary  institutions  outside  of  Michigan 

Lapeer  Home  and  Training  School 

i' 

5 
6 

State  charitable  or  educational  institutions 

8 

Insane  hospitals 

1 
4 

2 
39 

County  Infirmaries 

Private  orphan  asylums 

Number  of  other  relatives  who  had  been  in: 

Adrian  Industrial  Home 

1 

30 

4 
24 

8 

7 
24 

3 

4 
2 

7 
4 

4 
3 

12 

3 
14 

1 

2 

16 

2 

5 
5 
3 

42 

7 

Lansing  Industrial  School 

2 

1 
1 
4 

38 

State  prisons 

House  of  Correction 

9 
9 

Jails 

Correctionary  institutions  outside  of  Michigan 

40 
3 

6 

State  charitable  or  educational  institutions 

2 

2 

2 

1 


4 

1 

12 

State  Public  School 

9 

County  Infirmaries 

7 

Private  orphan  asylums 

3 

Total  institutional  record  of  relatives  (parents,  fratern- 
ity and  other  relatives) : 
Adrian  Industrial  Home 

5 
6 

35 

49 

40 
55 

15 

75 

8 

8 

19 

28 

107 

14 

8 

24 

7 

5 

16 

33 

19 

61 

2 

5 

5 

17 

87 

4 
26 
5 
4 
8 
12 

34 

Lansing  Industrial  School 

136 

Ford  Republic 

10 

House  of  Good  Shepherd 

1 
4 
1 
8 

1 
4 

3 
27 

9 
22 

4 

5 
32 

3 
11 

6 
12 

4 
31 
10 
30 

5 

6 
36 

3 
11 
10 
13 

13 

State  prisons 

24 
45 

Jails 

Correctionary  institutions  outside  of  Michigan 

State  Public  School 

194 
14 

12 
50 

State  charitable  or  educational  institution 

12 

County  Infirmaries 

9 

,     Insane  hospitals 

4 
1 

24 

Private  orphan  asylums 

45 

♦Schools  for  the  deaf,  blind,  etc. 

tin  those  cases  where  there  were  two  of   the  fraternity  in  the  school   at  the  time  of  the  investi- 
gation, only  one  was  considered  as  having  a  fraternity  in  the  institution. 


147 

TABLE  35. — Adrian  and  Lansing  Industrial  Schools. 
GENERAL  PARENTAL  FACTS. 


TTqa  f\f  alpnlinl 

Adrian. 

Lansing. 

N. 

F. 

T. 

N. 

F. 

T. 

Number  of  children  whose  fathers  drank: 

Amount  unknown 

34 

108 

142 

149 
10 
93 

98 

4 

68 

247 

Moderately 

14 

Excessively 

12 

29 

41 

161 

Total 

46 

137 

183 

252 

170 

422 

■ — — —  - .  .^      . 

Number  of  children  whose  mothers  drank: ' 

Amount  unknown 

9 
1 

32 

4 

41 
5 

22 
10 

20 
5 

42 

Excessively 

15 

Total 

10 

36 

46 

32 

25 

57 

Number  of  families  that  had  received  aid  from  city  or 
county 

10 

45 

55 

62 

69 

131 

TABLE  36. — Adrian  and  Lansing  Industrial  Schools. 
FRATERNITY. 


Adrian. 

Lansing. 

N. 

F. 

T. 

N. 

F. 

T. 

Number  of  families  in  which  the  children  numbered: 
One 

11 
15 
17 
17 
6 

11 
10 
8 
2 
2 
3 

2 

10 
23 
27 
34 
30 

33 
29 
37 
16 
14 
6 

6 
3 
4 

21 
38 
44 
51 
36 

44 
39 
45 
18 
16 
9 

8 
3 
4 

37 
44 
52 
81 
71 

52 
48 
44 
28 
13 
6 

6 
3 

19 
18 
39 
53 
45 

42 
23 
24 
20 
9 
6 

4 
2 

56 

Two 

62 

Three             

91 

Four 

134 

Five                                 

116 

Six 

94 

Seven                 

71 

Eight .'.        

68 

Nine 

48 

Ten                                

22 

Eleven 

12 

Twelve                    

10 

Thirteen 

5 

Fifteen                                              

1 
1 
9 

1 
""8 

2 

i 

5 

i 

9 

1 

Unknown 

4 

17 

Total                               

108 

278 

386 

496 

313 

809 

TABLE  37. — Adrian  and  Lansing  Indixstrial  Schools. 
CIVIL  STATUS  OF  PARENTS. 


Adrian 

Lansing. 

N. 

F. 

T. 

N. 

F. 

T. 

Number  of  families  in  which: 

The  parents  are  living  together 

31 
65 

70 

191 

3 

14 

101 

256 

3 

26 

198 

278 

2 

18 

138 

157 

4 

14 

336 

The  parents  are  not  living  together 

435 

The  child  was  an  adoptecl  member 

6 

The  condition  is  unknown 

12 

32 

■ 
Total , 

108 

278 

386 

496 

313 

809 

Number  of  families  broken  up  by: 

Death  of  the  mother 

17 

17 

3 

21 

62 
54 

8 
47 

7 
13 

79 
71 
11 
68 
7 
20 

72 
71 
15 
84. 
7 
29 

46 
44 

6 
46 

5 
10 

118 

Death  of  the  father 

115 

Death  of  both  parents 

21 

Separation  or  divorce 

130 

Desertion  of  the  mother 

12 

Desertion  of  the  father 

7 

39 

Total 

65 

191 

256 

278 

157 

435 

Number  of  parents  who  were  remarried: 

Widows 

7 
7 
5 
3 
4 

29 
27 
21 
12 
6 

36 
34 
26 
15 
10 

32 
41 
34 
11 
7 
3 

23 

21 

19 

8 

3 

1 

55 

Widowers 

62 

Separated  or  divorced  mothers 

53 

Separated  or  divorced  fathers .          

19 

Deserted  or  deserting  mothers 

10 

Deserted  or  deserting  fathers 

4 

Total 

26 

96 

121 

128 

75 

203 

Disposition  of  children.* 

Of  widows:* 

Children  placed  with  relatives 

5 

5 

5 
2 

14 
3 

10 
1 

9 
2 
32 
4 
3 

2 

7 
2 

2 
2 

6 

■"is" 

5 
3 

7 

Children  placed  in  institutions 

2 

Of  widowers: 

Children  placed  with  relatives 

1 

3 

1 

4 

4 

1 

6 

21 

Children  placed  in  institutions 

5 

Where  both  parents  died: 

Children  placed  with  relatives 

2 

12 

Children  placed  in  institutions 

3 

Of  divorced  or  separated  parents: 

Children  placed  with  relatives 

4 

3 
3 

1 

4 
1 
5 
4 
3 

15 

Children  placed  in  institutions 

2 

Mother  kept  child 

2 

1 
2 

50 

Father  kept  child 

9 

Both  kept  child 

6 

*While  these  figures  do  not   give  the  facts  concerning  the 
give  the  facts  for  all  those  placed  in  institutions. 


disposition  of  all  the  children,  It    does 


149 


TABLE  38. — Mentality  of  County  Infirmary  population. 


M. 

F. 

■ 
T.    • 

Feebleminded 

382 
70 

249 
58 

328 
44 

158 
23 

710 

Epileptic 

1 14 

I  nsane 

407 

Of  X  mentality 

81 

Total  insane  and  defective  group 

759 

553 

1   312 

Normal 

1,680 
18 

257 
19 

1   937 

Neurotic 

37 

Total  normal  group 

1,698 

276 

1,974 

33 

15 

48 

2,490 

844 

3,334 

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TABLE  40. — Forms  of  insanity  in  County  Infirmaries. 


Senile  dementia 

General  paralysis  of  the  insane. 

Manic  depressive  insanity 

Dementia  praecox 


Paranoid  forms 

Alcoholic  insanities .  . 
Chorea  with  insanity. 
Traumatic  insanity .  . 


Morphinism 

Hysteria 

Form  unknown 

Insanity  questionable . 


Total . 


M. 

F. 

T. 

133 

94 

227 

22 

3 

25 

11 

6 

17 

8 

10 

18 

3 

3 

6 

6 

4 

3 

7 

3 

3 

1 

1 

1 

1 

49 

34 

83 

9 

7 

16 

249 

158 

407 

TABLE  41. — Nativity  of  County  Infirmary  population 

Normal. 

Neurotic. 

Insane. 

F.  M. 

Epileptic. 

X. 

? 

Total. 

Place  of  birth  unknown 

Austria 

13 

19 
9 

217 
7 

102 

21 

11 

270 

29 

8 

140 

7 
17 
19 

7 

18 
44 
51 
13 
19 

1 

26 

>      1 
1 

42 
3 

24 

4 

1 

44 

6 

56 

2 

2 

60 

11 

4 

5 
1 

116 
23 

Belgium 

12 

Canada  

3 

7 

11 

4 

1 
2 

344 

Denmark 

11 

England — Wales 

3 

18 

3 

1 
30 
10 

2 

11 

1 
6 
1 

4 

2 

1 

155 

Finland 

29 

France ....          

2 
5 

1 

2 

8 

17 

Germany — Prussia 

8 

5 

370 

Holland 

46 

Hunearv 

1 

11 

Ireland .      .              

21 

2 

4 

178 

Italy 

8 

Norway 

3 

1 



27 

German  Poland 

20 

Russian  Poland 

3 

10 

Russia                           

1 
5 
3 

1 
2 

1 

20 

Scotland .            

1 

4 
8 
2 

2 
3 

1 

67 

Sweden 

1 

66 

Switzerland .  . 

16 

Other  Countries 

1 

2 

24 

Total  foreign  born 

1,028 

15 

167 

159 

26 

32 

17 

1,444 

Michigan 

348 

17 
251 
92 
51 
11 

52 
42 
31 

1 

8 

63 

7 
89 
18 
11 

4 

10 
6 
6 

324 

19 
63 
46 
11 

1 

10 
4 

12 
5 

49 

2 
11 

17 

1 

17 

2 

2 

17 

1 

4 

..  .  . 

826 

Indiana 

47 

New  York 

5 
4 

440 

Ohio.  .  . 

167 

Penn.sylvania . .        

77 

16 

New  England  States 

2 
1 

1 

2 

1 
2 
1 

1 
1 

1 

78 

Southern  States 

58 

Western  States 

S7 

State  unknown 

8 



Total  native  born 

896 

21 

214 

495 

77 

45 

26 

1,774 

Michigan: 

County  born 

180 
20 

6 

29 
6 

196 
25 

33 

2 

11 

1 

14 

1 

469 

County  unknown 

55 

164 

TABLE  42. — Number  of  foreign  born  in  the  different  mental  classifications  of  County  Infirmary 
population.  Aho,  in  each  case,  the  number  per  10,000  of  the  total  foreign  born  population 
in  the  state. 

ACTUAL  NUMBER. 


County. 


Normal 
group. 


Feeble- 
minded 

and 
epileptic. 


Total 

insane 

and 

defective 

group. 


Total 
popula- 
tion. 


Alcona 

Alger 

Allegan 

Alpena 

Antrim 

Baraga 

Barry 

Bay 

Benzie 

Berrien 

Branch 

Calhoun 

Cass 

Charlevoix .... 
Cheboygan 

Chippewa 

Clare 

Clinton 

Crawford 

Delta 

Dickinson 

Eaton 

Emmet 

Genesee 

Gladwin 

Gogebic 

Grand  Traverse 

Gratiot 

Hillsdale 

Houghton 

Huron 

Ingham 

Ionia 

Iosco 

Iron 

Isabella 

Jackson 

Kalamazoo 

Kalkaska 

Kent . 

Lake 

Lapeer 

Leelanau 

Lenawee 

Livingston 

Luce 

Macomb 

Manistee 

Marquette 

Mason 

Mecosta 

Menominee.  .  .  . 

Midland 

Missaukee 

.Monroe 


1 
6 
6 

8 
4 

6 
2 

24 
5 

12 

0 
3 
0 
3 

7 

7 
2 
3 
4 
37 

12 
4 
0 

16 
3 

8 
4 
4 
3 
43 

8 
7 
7 
4 
6 

6 
8 

16 
3 

39 

1 
5 
3 
5 
4 

1 
11 
30 
20 
15 

4 
11 
3 
5 
5 


0 
0 
1 
2 
4 

0 
0 
3 
1 
2 

1 
3 
0 
0 

4 

0 
0 
1 
1 
6 

1 
1 
0 
4 
1 

3 
0 
1 
1 
5 

4 
1 
1 
2 
0 

3 
1 
4 
0 
11 

0 
6 
1 
0 
3 

0 
0 
5 
7 
0 

2 
4 
1 
0 
1 


1 
1 
5 
4 
4 

0 
1 
8 
1 
4 

1 
7 
0 
1 
7 

3 
0 
1 
1 

7 

2 
3 
0 

8 
2 

4 
0 

1 
1 

14 

7 
3 
5 
4 
2 

3 
3 

4 

0 

18 

0 
6 
1 
3 
4 

0 

3 

11 

.10 

2 

2 
.5 
2 
0 
3 


2 

7 
11 
12 

8 

6 
3 

32 
6 

16 

1 

10 

0 

5 

14 

10 
2 
4 
5 

44 

14 
7 
0 

24 
5 

12 
4 
5 
4 

58 

15 
10 

12 
8 
8 

8 
11 
20 

3 
58 

1 

11 
4 

8 
8 

1 
14 
41 
30 
19 

6 

17 
.5 
5 

8 


155 

TABLE  42.— Continued. 
ACTUAL  NUMBER. 


County. 


Normal 
group. 


Feeble- 
minded 

and 
epileptic. 


Total 

insane 

and 

defective 

group. 


Total 
popula- 
tion. 


Montcalm.  .  . 
Montmorency 
Muskegon.  .  . 
Newaygo.  .  .  . 
Oakland 

Oceana 

Ogemaw 

Ontonagon.  . . 

Osceola 

Otsego 

Ottawa 

Presque  Isle. . 
Roscommon . . 

Saginaw 

Sanilac 

Schoolcraft . . . 
Shiawassee . . . 

St.  Clair 

St.  Joseph 

Tuscola 

Van  Buren . .  . 
Washtenaw .  . 

Wayne 

Wexford 


1 
2 

20 
4 

12 

3 

2 

14 

7 
4 

6 
5 
1 
22 
9 

6 
1 
17 
2 
6 

2 

9 

420 

5 


0 
1 
1 
0 
3 

3 
0 
0 
3 
2 

6 
3 
0 

7 
2 

0 

0 

10 

0 

4 

1 

2 

35 

0 


0 
2 
9 
2 
11 

3 
1 
0 
4 
2 

13 

7 

0 

18 

8 

2 
3 

17 
0 
8. 

1 

4 

76 

0 


1 

4 
29 

6 
23 

6 

3 

14 

11 

6 

19 
13 
1 
40 
17 

8. 

4 
34 

2 
14 

3 

13 

506 

5 


NUMBER  PER   10.000  FOREIGN   BORN   POPULATION. 


County. 

Normal 
group. 

Feeble- 
minded 

and 
epileptic. 

Total 

insane 

and 

defective 

group. 

Total 
popula- 
tion. 

Alcona  ...      .        ". 

7.2 
19.1 
14.3 
14 
15.6 

26.9 

15.2 

15 

40.3 

15.1 

0 

5.8 

0 
10.2 
17.6 

7.4 
16.2 
18.2 
47.1 
39.3 

14.5 
30.8 
0 
17.2 
20.3 

0 
0 

2.4 

3.5 

15.6 

0 

0 

1.9 

8.1 

2.5 

7.8 
5.8 
0 
0 
10.1 

0 
0 

6.1 

11.8 

5.2 

1.2 

7.5 

0 

4.3 

6.8 

7.2 
3.2 

11.9 
7 

15.6 

0 

7.6 

5 

8.1 

5 

7.8 
13.6 

0 

3.4 
17.6 

3.2 
0 

6.1 

11.8 

7.2 

2.4 
22.6 

0 

8.6 
13.5 

14.5 

Alger 

22.3 

Al  egan ^ 

26.2 

Alpena 

21 

Antrim 

31.2 

Baraga 

26.9 

Barry 

22.8 

Bay 

20 

Benzie 

48.3 

Berrien 

20.1 

Branch .  .                  . .  . . : 

7.8 

Calhoun .  .              

19.4 

Cass 

0 

Charlevoix .                                     

17.1 

Chebovean                       

35.2 

Chippewa 

10.6 

Clare.                .  . .  .^. .  . 

16.2 

Clinton ! 

24.2 

Crawford  .  r : "  —     '    .        

58.8 

Delta ...         

45.5 

Dickinson 

16.95 

Eaton                                

52.6 

Emmet .              

0 

Genesee                                     

25.8 

Gladwin 

33.8 

156 

TABLE  42.— Concluded. 
NUMBER  PER    10,000  FOREIGN   BORN   POPULATION. 


County. 


Gogebic 

Grand  Traverse 

Gratiot 

Hillsdale 

Houghton 

Huron 

Ingham 

Ionia 

Iosco 

Iron 

Isabella 

Jackson 

Kalamazoo 

Kalkaska 

Kent 

Lake 

Lapeer 

Leelanau 

Lenawee 

Livingston .  ,  . . . 

Luce 

Macomb 

Manistee 

Marquette 

Mason 

Mecosta 

Menominee.  .  .  . 

Midland 

Missaukee 

Monroe 

Montcalm 

Montmorency.  . 

Muskegon 

Newaygo 

Oakland 

Oceana 

Ogemaw 

Ontonagon 

Osceola 

Otsego 

Ottawa 

Presque  Isle. .  . . 
Roscommon. .  . . 

Baginaw 

Sanilac 

Schoolcraft 

Shiawassee 

St.  Clair 

St.  Joseph 

Tuscola 

Van  Buren 

Washtenaw .... 

Wayne 

Wexford 


Normal 
group. 

Feeble- 
minded 

and 
epileptic. 

Total 

insane 

and 

defective 

group. 

Total 
popula- 
tion. 

7.2 

1.8 

3.6 

10.7 

11.96 

0 

0 

11.96 

20.3 

5.1 

5.1 

25.4 

30.4 

10.1 

10.1 

40.6 

12.9 

1.5 

4.2 

14.4 

8.1 

4.1 

7.1 

15.3 

12.9 

1.8 

5.5 

18.4 

23.8 

3.4 

17 

40.9 

16.8 

8.4 

16.8 

33.5 

8.7 

0 

2.9 

11.6 

18.6 

11.1 

11.1 

29.7 

13.4 

1.7 

5 

18.4 

18.1 

4.5 

4.5 

22.8 

31.6 

0 

0 

31.6 

10.95 

3.1 

5.1 

16.3 

11.4 

0 

0 

11.4 

12.8 

15.3 

15.3 

28.1 

16.4 

5.5 

5.5 

21.9 

14.3 

0 

8.6 

22.9 

26.5 

19.9 

26.5 

53.1 

6.1 

0 

0 

6.1 

20.4 

0 

5.6 

26 

44.6 

7.4 

16.4 

60.9 

11.2 

3.9 

5.6 

16.7 

33.4 

0 

4.5 

42.4 

15.8 

7.9 

7.9 

23.6 

16.1 

5.9 

7.3 

24.9 

14.6 

4.9 

9.7 

24.3 

29.4 

0 

0 

29.4 

15.8 

3.2 

9.5 

25.3 

2.7 

0 

0 

2.7 

26.3 

13.1 

26.3 

52.6 

20 

1 

9 

29 

17.1 

0 

8.5 

25.6 

17 

4.3 

15.6 

32.7 

13.8 

13.8 

13.8 

27.7 

12.4 

0 

6.2 

18.5 

47.7 

0 

0 

47.7 

25.5 

10.9 

14.5 

40 

29.5 

14.8 

14.8 

44.3 

6.2 

6.2 

13.4 

19.6 

22.3 

13.4 

31.4 

58.1 

25.6 

0 

0 

25.6 

11.3 

3.6 

9.3 

20.6 

10.1 

2.2 

8.99 

19.1 

21.9 

0 

7.3 

29.2 

2.6 

0 

7.8 

10.4 

13.3 

7.8 

13.3 

26.6 

11.4 

0 

0 

11.4 

9.7 

6.5 

12.9 

22.6 

7.9 

3.9 

3.0 

11.8 

16.5 

3.7 

7.3 

23.8 

24.5 

2 

4.4 

29.5 

15.8 

0 

.  0 

15.8 

157 


TABLE  43. — Nativity  of  parents  of  County  Infirmary  population. 


Normal. 

Neurotic. 

Insane. 

F.M. 

Epileptic. 

X. 

7 

Total. 

Place  of  birth  unknown 

Austria 

184 

35 

18 

272 

16 

271 

44 
41 
649 
69 
15 

681 
15 
33 
33 
15 

35 

186 

103 

25 

33 

7 

184 

I 

49 

6 

51 

7 
12 
89 
17 

478 

2 

7 

88 

67 
2 

37 

21 
3 

978 

44 
28 

Belgium 

Canada 

Denmark 

6 

14 

9 

3 
2 
3 

■'i' 

13 

'i' 

4 
2 

441 
24 

England — Wales 

7 

63 

8 
11 
99 
31 

2 

92 
2 

7 
4 

15 

10 

2 

4 

18 

2 

420 
61 

Finland 

France 

Germany — Prussia 

Holland 

5 
15 

5 

18 

4 

79 
901 
12.S 

Hungary 

18 

Ireland 

Italy 

3 

73 

5 
2 

24 
.2' 

882 
21 

Norway 

4 

46 

German  Poland 

37 

Russian  Poland 

5 

1 

21 

Russia 

5 

21 

7 

3 

11 

4 

1 

44 

Scotland 

Sweden 

1 

is 

11 
4 
8 

3 
6 

4 

231 

127 

Switzerland 

32 

Other  countries 

1 

2 

2 

7 

64 

Total  foreign  born 

2,589 

38 

356 

463 

72 

82 

44 

3,644 

Michigan 

Indiana 

103 

11 
462 
90 
92 
25 

172 

101 

8 

37 

4 

15 

1 

140 

18 

22 

11 

46 
11 

113 

11 

179 

54 

47 

5 

30 
8 

7 
25 

32 

3 
28 

4 
11 

1 

"27' 
2 

4 

13 

1 
5 
1 
2 

281 
27 

New  York 

5 
3 
3 
1 

9 
2 

846 

Ohio 

Pennsylvania 

New  Jersey 

172 

181 

42 

3 
1 
4 
3 

6 
1. 

6 

1 

271 

Southern  States 

125 

Western  States 

19 

State  unknown 

2 

10 

2 

3 

82 

Total  native  born 

1,101 

29 

274 

479 

89 

43 

31 

2,046 

SUMMARY  OF  NATIVITY  OF  PATIENTS'  PARENTS. 


Both  parents  foreign  born 

One  parent  foreign  born 

Both  parents  native  born 

One  parent  native  born,  one  unknown 
Both  parents  unknown 


Normal 
group. 


1,232 

167 

482 

42 

51 


Insane. 


162 
32 

118 
16 
79 


F.  M. 


198 
69 

195 
39 

209 


Insane 

and 

defective. 


430 
118 
360 
72 
332 


Total. 


1,680 
291 
855 
118 
390 


158 


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25  to  29  years .  .  . 
30  to  34  years .  .  . 
35  to  39  years .  .  . 
40  to  44  years .  .  . 
45  to  49  years .  .  . 

50  to  54  years .  .  . 
55  to  59  years .  .  . 
60  to  64  years.  .  . 
65  to  69  years .  .  . 
70  to  74  years .  .  . 

75  to  79  years 

80  to  84  years .  .  . 
85  to  89  years .  .  . 
90  to  94  years .  .  . 
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TABLE  46. — Previous  occupations  of  Ike  men  in  the  County  Infirmaries. 


Number  of  individuals 
whose  occupation  was: 

N. 

I. 

F. 

I. 

and 
D. 

Total. 

N. 

I. 

F. 

I. 

and 
D. 

Total. 

Unknown 

140 
488 
195 
612 

63   1      169  !      971 

427 

A  trade* 

48           24 
48           49 
65         1 1  •"> 

89 
124 
217 

580 

Farmer  (or  farm  laborer) . . 

320 

Common  laborer 

840 

Professional: 
Journalist 

2 
2 
3 

i 

2 

1 

2 

4 
4 

Teacher 

2 

Veterinary  surgeon 

Chiropodist 

1 

1 

1 

Contractor 

1 

1 
1 
1 

Lawyer 

, 

Musician 



Physician 

i 

Total.  . 

] 

1 

11 

4 

1 

6 

17 

Commercial : 

Clerk 

13 

7 
6 
4 
3 

1 
1 
1 

1 

2 
2 

2 
2 

15 
9 
6 
5 

Merchant 

Salesman 

■  ■«■    ■ 

Bookkeeper 

1 

1 

Telegraph  operator 

3 

Canvasser 

1 

1 

2 

1 
1 

1 

Collector 

Manufacturer 

1 

Stenographer 

j 

. 

Total 

] 

37 

6 

6 

43 

Other  occupations: 

Lumberman 

97 
36 
26 
11 
8 

8 
5 
3 
4 

1 

2 
2 

1 
1 

6 

2 
3 

1 

14 
2 

22 
6 

119 
43 
31 
16 
10 

9 
6 
4 
4 
3 

2 
2 

Miner 

Sailor 

3   '          5 
2    '           ."i 

Peddler 

Bartender 

1 

2 

Porter 

Fishermen 

1 

{ 

Jockey 

Waiter 



Saloonkeeper 

1 

1 

2 

. 

Janitor 

Nurse 

' 

Billposter 

Bootblack . . 

Brewer 

1 

1 

Clothes  cleaner 

1 
1 

1 
1 

Deputy 

Gambler 

Hunter 

1 

1 

News  agent 

1 
1 
1 
1 
1 
1 

Night  watchman 

Policeman 

Real  estate 

Sealer 

Trapper 

Total 

215 

15 

24 

46 

263 

Total  of  all  occupations. . . 

1,698 

249 

382 

759      2,490 

♦Trades  include  the  following:  barber,  bench  hand,  blacksmith,  boiler-maker,  bricklayer,  butcher, 
cabinet-maker,  carpenter,  cigar-maker,  cook,  coppersmith,  core-worker,  engineer,  machinist,  metal 
polisher,  moulder,  painter,  pattern-maker,  plumber,  sign  writer,  ship  carpenter,  shoemaker,  steam 
fitter,  tailor,  tinsmith,  watch  maker,  wood  worker. 


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TABLE  54. — Fraternities  of  County  Infirmary  inmates. 


Fraternities  of  County,  Infirmary  inmates. 

Normal, 

neurotic, 

questionable. 

Feebleminded, 

epileptic, 
insane  and  X. 

Total. 

■ 
Numbep-of  individuals  whose  families  numbered: 
One  child 

5 
36 
52 
68 
60 

58 
71 
67 
48 
43 

25 

20 

8 

8 

2 

13 

45 
47 
41 
38 

40 
41 
30 
26 
21 

14 

14 

•     5 

5 

3 

4 

18 

Two  children 

81 

Three  children 

99 

Four  children 

109 

Five  children 

98 

Six  children 

98 

Seven  children 

112 

Eight  children 

97 

Nine  children 

74 

Ten  children 

64 

Eleven  children 

39 

Twelve  children 

34 

Thirteen  children 

13 

Fourteen  children 

13 

Fifteen  children 

5 

Sixteen  children 

5 

Seventeen  children 

1 

Eighteen  children 

1 

1 

Twentv  children 

1 

1 

577 
6.793 

387 
6.136 

964 

Average  number  of  children  per  family 

6.53 

173 


TABLE  55. — Facts  in  regard  to  families  and  relatives  of  County  InHrmary  inmates. 


Number  of  families  having  in  the  County  Inflrmarj'^  now: 

Two  members 

81 

Three  members 

10 

Four  members .    . . 

2 

Five  members 

1 

Seven  members 

2 

Total 

96 

Total  number  of  individuals  in  the  County  Inflnnary  who  had  a  relative  there  at  the  tune  of  the 
interview 

219 

Institutional  history  of  relatives. 

Blood 
relation. 

Relatives 

by 
marriage. 

Total  all 
relatives. 

Number  of  individuals  whose  relatives  in  the  County  Infirmary 
nu  mbered :                      • 
One          

109 

29 

11 

8 

4 

2 

167 

Two    

29 

Three 

12 

P'our 

10 

Five    

3 

Six 

2 

Seven 

1 

Eight 

2 

3 

Total  all  individuals 

165 

227 

Number  of  individuals  whose  consorts  are  either  in  the  County 
Infirmary  or  have  been 

117 

Total  number  of  relatives  who  have  been  in: 
County  Infirmary* 

280 

20 

1 

76 

6 

25 

50 

7 

4 

8 

359 

Other  County  Infirmaries 

4 

24 

Howell  State  Sanatorium 

1 

State  Public  School 

76 

Adrian  and  Lansing  Industrial  Schools 

6 

Lapeer  Home  and  Training  School 

2 
25 
13 

27 

State  Hospitals  for  the  Insane 

75 

State  Prisons 

20 

Detroit  House  of  Correction 

4 

Jails 

7 

15 

Number  of  individuals  whose  feebleminded  relatives  number: 
One                           .    .        .        

53 
21 
10 
9 
1 
3 
1 
1 

Two    

Three                 .                                                                ..... 

Four 

Five 

Seven         

Ten              .           

Total  number  individuals  .                            

99 

♦Total  number  of  relatives  who  have  been  in  the  same  County  Infirmary  as  was  the  patient  interviewed 
by  the  investigator. 


174 


TABLE  55. — Concluded. 


■ 

Blood 
relation. 

Relatives 

by 
marriage. 

Total  all 
relatives. 

Total  number  of  relatives  who  were: 

Feebleminded 

Epileptic 

204 
45 
90 
13 
9 
25 

23 

1 

37 

3 

227 
46 

Insane 

127 

Suicides 

16 

Choreic 

9 

Sexually  irregular* 

25 

♦NOTE. — This  class  includes  only  those  about  whom  very  definite  and  often  detailed  evidence 
pointed  to  sexual  immorality. 


TABLE  56. — Average  number  of  years  the  individuals  of  different,  mental  status  have  been 
in  County  Infirmaries  urith  average  cost  of  maintenance  per  individual. 


Number 

Mental  status. 

Average  total  duration  of  County 
Infinimry  residences  with  cost. 

• 

Average  last  (present)'County  Infirmary 
residence  with  cost. 

individ- 
uals. 

Average 
duration 
in  years. 

1 
Average     i     Total  cost 
cost  per      !          of  all 
individual*      individuals. 

Average 
duration 
in  years. 

Average 

cost  per 

individual. 

Total  cost 

of  all 
individuals.* 

710 

407 

1,312 

1,974 

2,490 
844 

Feeblem'd,  male  and  female.. 

Insane,  male  and  female 

Ins.  and  def.,  male  and  fern. . 
Nor'l  and  neurotic,  m.  and  f . 

Total  males 

Total  females 

9.32 
6.28 
7.83 
3.23 

4.17 
7.55 
6.03 

$1,419  11 

090  81 

1,219  92 

552  72 

683  55 

1,174  07 

804  34 

$1,007,568  10 

403,259  67 

1,600,535  04 

1,091,069  28 

1,602,039  50 

990,915  08 

2,681,669  56 

8.44 
5.94 
7.20 
2.34 

3.34 

6.92 
4.25 

81,299  44 

948  63 

1,115  26 

415  03 

572  46 

1,090  80 

696  15 

$922,502  40 

386,092  41 

1,463,221  12 

819,269  22 

1,425,425  40 
920,635  20 

3,334 

Total  male  and  female 

2,320,964  10 

♦The  average  cost  was  figured  on  the  basis  of  the  average  weekly  per  capita  costs  of  maintenance 
("after  deducting  value  of  farm  purchased  and  building  erected")  as  given  in  the  Annual  Abstract  of 
the  Report  of  the  Superintendents  of  the  Poor  in  the  State. 


175 


TABLE  57. — Cost  of  maintenance  of  one  family  in  a  County  Infirmary. 

SEE  CHART   NUMBER   11. 


Generation. 

Individual's 
Chart  No. 

Dates  of 
County  Infirmary  residence. 

Cost  for 
maintenance.* 

II 

Ill ] 1 

31a 

16 

34 

121 

122 

24 

26 

84 

85 

9 

10 

3/3/94-3/8/94 

10/9/97-11/9/97 

1/10/04-11/5/13 

5/20/86-8/27/07 
5/25/04-d-10/20/05 
5/22 /07-d-l  1/2/13 
10/71-11/3/13 

8/1/00-4/1/01 
9/19/0.3-d-9/26/03 
7/8/10-3/8/11 
9/5/10-11/8/10 

b.  5/22/67-d-5/22/67 
b.     /87— ?** 
3/10/00-7/1/00 
4/6/00-7/1/00 

$1,601  59 

2,728  14 
193  09 

1 

IV 

V 

6,708  .50 
6.073  39 

78  11 
124  57 

36  32 
27  63 

Total  cost 

$17,573  97 

♦Total  cost  of  maintenance  was  figured  on  the  average  weekly  per  capita  cost  for  maintenance  a.^ 
given  in  the  Annu9.1  Abstract  of  the  Reports  of  the  Superintendents  of  the  Poor  in  the  State. 
**No  County  Infirmary  record  of  his  discharge. 


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